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目的 :研究性别对原发性高血压 (EH)患者抗高血压药物治疗后胰岛素抵抗 (IR)、血糖和血脂变化的影响。方法 :1 3 3例轻中度EH患者被随机分为 3组 ,分别用复方降压片治疗 (第 1组 ,3 9例 ) ,福辛普利和吲哚帕胺联合治疗 (第 2组 ,48例) ,尼群地平和阿替洛尔联合治疗 (第 3组 ,46例 ) ,每组分为男、女性两亚组。疗程 1 4个月。以根据Cederholm公式计算的胰岛素敏感指数 (ISI)为IR指标 ,观察血压、血糖、血脂的变化。结果 :①第 1组和第 2组的降压效果 ,女性比男性显著 ;性别对第 3组的降压效果无显著影响。②第 1组患者治疗后男女两亚组ISI升高和血糖下降的幅度、血脂的变化差异均无统计学意义。③第 2组患者治疗后男女两亚组ISI下降、血糖升高和高密度脂蛋白 /低密度脂蛋白比下降的幅度差异无统计学意义。④第 3组患者治疗后男性亚组血糖显著升高 ,高密度脂蛋白 /低密度脂蛋白比显著下降 ,ISI差异无统计学意义 ;女性组血糖、血脂和ISI无统计学意义。结论 :性别对长期用复方降压片治疗引起的EH患者胰岛素敏感性和糖代谢改善无影响 ;对长期福辛普利和吲哚帕胺联合治疗引起的IR加重及血糖和血脂代谢恶化无影响 ;长期尼群地平和阿替洛尔联合治疗不利于男性EH患者血糖和血脂代谢 ,对女性无影响
Objective: To study the effects of gender on the changes of insulin resistance (IR), blood glucose and blood lipids in patients with essential hypertension (EH) after antihypertensive treatment. Methods: One hundred and thirty-three patients with mild-to-moderate EH were randomly divided into 3 groups, treated with compound antihypertensive tablets (group 1, 39 patients), combination of fosinopril and indoxapamine (group 2, 48 cases), nitrendipine and atenolol combination therapy (group 3, 46 cases), each group is male and female two subgroups. Treatment of 1 4 months. The insulin sensitivity index (ISI) calculated by the Cederholm formula was used as an index of IR to observe changes of blood pressure, blood sugar and blood lipid. Results: ① The antihypertensive efficacy of Group 1 and Group 2 was significantly higher than that of males; sex had no significant effect on the antihypertensive effect of Group 3. ② There was no significant difference in the range of ISI and blood glucose between the two groups after treatment in the first group of patients. (3) There was no significant difference in the decrease of ISI, the increase of blood glucose and the decrease of high density lipoprotein / low density lipoprotein ratio between the two groups after treatment in the second group of patients. ④ After treatment, the blood sugar of male subgroups increased significantly, the HDL / LDL ratio decreased significantly, and there was no significant difference in ISI between the three groups. The blood glucose, blood lipid and ISI in female group were not statistically significant. Conclusion: Gender has no effect on insulin sensitivity and glucose metabolism in EH patients caused by long-term compound antihypertensive tablets treatment; it has no effect on the IR exacerbation caused by long-term combination of fosinopril and indoxapamine and the deterioration of blood glucose and lipid metabolism; Long-term nitrendipine and atenolol combination therapy is not conducive to blood glucose and lipid metabolism in male patients with EH, no effect on women