珍菊降压片对高血压病患者血糖及胰岛素敏感性的影响(1)
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[摘要] 目的：观察珍菊降压片对高血压病患者血糖及胰岛素敏感性的影响。方法：选择75例初发轻、中度高血压病患者给予口服珍菊降压片,持续观察6个月,每隔2个月检查空腹血糖(FPG)、餐后2 h血糖(2 h PG)和空腹胰岛素(FIns),并同时测定血清钾(K+)、血清总胆固醇(TC)、三酰甘油(TG)，每隔2周观察1次血压变化情况。结果：珍菊降压片降压效果理想，68例患者血压控制在正常范围，有效率为90.67%。血糖及血清胰岛素水平与治疗前比较，无统计学意义(P>0.05)，说明使用珍菊降压片对高血压病患者的血糖水平及胰岛素的敏感性无影响。观察过程中未发现血清K+、血TC及TG有明显的改变。结论：珍菊降压片是一种安全和有效的治疗高血压药物。
[关键词] 高血压；珍菊降压片；血糖；胰岛素敏感性
[中图分类号] R544.1 [文献标识码] A[文章编号] 1673-7210(2010)11(b)-077-02
The effect of Zhenju Hypotensive Tablets on glucose and insulin sensitivity of patients with primary hypertension
CHEN Yong
(Department of Endocrinology, Tongling People's Hospital, Anhui Province, Tongling 244000, China)
[Abstract] Objective: To investigate the effect of Zhenju Hypotensive Tablets on glucose and insulin sensitivity. Methods: We treated 75 patients with primary hypertension using Zhenju Hypotensive Tablets for 6 months. Every two months, the blood glucose and serum insulin levels were measured after fasting and two hours post 2 prandial, and the serum potassium, cholesteral, triglyceride were also measured at the same time. Results: The results indicated that Zhenju Hypotensive Tablets had effects of lowering blood pressure, and 68 patients' blood pressure were controlled in normal range, the effects was 90.67%. The glucose level and serum insulin sensitivity were no significant change (P>0.05). After 6 month's treatment with oral Zhenju Hypotensive Tablets, there were no significant changes of serum potassium, cholesteral and triglyceride. Conclusion: These results suggest that Zhenju Hypotensive Tablets is an effective safe drug of treating primary hypertension.
[Key words] Hypertension; Zhenju Hypotensive Tablets; Glucose; Insulin sensitivity
有文献报道噻嗪类利尿剂会影响高血压病患者的糖代谢[1]。为了进一步观察珍菊降压片对高血压病患者血糖及胰岛素敏感性的影响，笔者给75例轻度高血压病患者口服珍菊降压片，持续随访6个月，每隔2个月复查空腹及餐后2 h血糖、空腹胰岛素水平以及有关的代谢指标，现将结果报道如下：
1 对象与方法
1.1对象
选取我院2009年2～8月门诊患者75例，其中，男39例，女36例，平均年龄(52.8±10.4)岁。均符合WHO高血压诊断标准[2]：血压在140～180/90～110 mm Hg(1 mm Hg=0.133 kPa)，均为门诊患者，经临床检查无任何靶器官损害证据，亦排除继发性高血压，无糖尿病史及高血糖临床表现。
1.2 方法
每例患者均在门诊给药并定期随访，给予珍菊降压片1～2片，每天3次。如血压控制不理想，收缩压(SBP)≥140 mm Hg或舒张压(DBP)≥90 mm Hg，则加用尼群地平片10～20 mg， 每天2～3次，将血压降至正常水平。
1.3观察指标
主要观察治疗前后的血压改变，每2周观察1次血压，为安静状态下坐位之右上臂血压。分别测定治疗前及治疗后2个月、4个月、 6个月的空腹血糖、餐后2 h血糖及空腹血清胰岛素水平。同时测定血清钾、血清TC和TG ......
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