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目的观察氯沙坦对糖尿病合并高血压患者胰岛素敏感性的影响。方法本试验入选了2004年2月～2006年1月北京友谊医院内分泌科和心血管内科诊治的糖尿病合并高血压患者58例。随机分为2组,分别接受氨氯地平(DM/A组)5mgQD,或氯沙坦(DM/L组)50mgQD治疗;入组前后分别测定体重指数(BMI)、收缩压(SBP)、舒张压(DBP)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)和空腹胰岛素水平(FPI),并计算胰岛素评估指数(HOMA-IR)。结果两组在经过12周治疗后,SBP和DBP较治疗前均显著降低(P<0.05);DM/L组经过氯沙坦12周治疗,FPI和HOMA-IR治疗后较治疗前降低(P<0.05);MS/L组FPI和HOMA-IR治疗后较治疗前下降(P<0.05)。结论糖尿病合并高血压患者,在经过氯沙坦12周治疗后,胰岛素敏感性提高,SBP和DBP显著下降;MS患者在经过氯沙坦12周治疗后,胰岛素敏感性提高。
Objective To observe the effect of losartan on insulin sensitivity in diabetic patients with hypertension. Methods In this study, 58 patients with diabetes mellitus and hypertension were diagnosed and treated in Department of Endocrinology and Cardiology of Beijing Friendship Hospital from February 2004 to January 2006. The patients were randomly divided into 2 groups and received amlodipine (DM / A group) 5mgQD, or losartan (DM / L group) 50mgQD respectively. Body mass index (BMI), systolic blood pressure (SBP) DBP, HbA1c, fasting plasma glucose (FPG) and fasting insulin (FPI) were calculated and insulin assessment index (HOMA-IR) was calculated. Results The SBP and DBP in both groups decreased significantly (P <0.05) after treatment for 12 weeks. After treatment with losartan for 12 weeks in DM / L group, FPI and HOMA-IR decreased after treatment (P <0.05). The levels of FPI and HOMA-IR in MS / L group decreased after treatment (P <0.05). Conclusions In patients with diabetes mellitus and hypertension, after 12 weeks of treatment with losartan, the insulin sensitivity and the SBP and DBP were significantly decreased. The MS patients’ insulin sensitivity increased after 12 weeks of treatment with losartan.