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目的:观察替米沙坦对糖尿病合并高血压患者胰岛β细胞功能的影响,探索血管紧张素Ⅱ阻断剂降压以外的胰岛功能修复作用。方法:70例糖尿病合并轻、中度高血压的患者随机分为替米沙坦治疗组和氨氯地平治疗组,每组35例患者;替米沙坦治疗组在控制血糖的治疗上给予替米沙坦进行降压治疗;氨氯地平治疗组在控制血糖的治疗上给予氨氯地平进行降压治疗;两组的观察周期均12周,每2周观察1次血压、空腹血糖、并记录低血糖及其它不良反应。治疗前后测糖化血红蛋白(HbAlc)、餐后2小时血糖,并按照HOMA稳态模型公式计算胰岛β细胞功能指数(HOMA-β)和胰岛素抵抗指数(HOMA-IR)。结果:两组患者在降压效果方面无显著性差异,收缩压、舒张压对比,P>0.05;与氨氯地平组比较,替米沙坦组胰岛素峰值和HOMA-β显著升高,HOMA-IR则显著降低。结论:替米沙坦可更显著改善糖尿病合并高血压的患者的胰岛β细胞功能,具有降压以外的改善胰岛细胞功能的作用。
OBJECTIVE: To observe the effect of telmisartan on pancreatic β-cell function in patients with diabetes mellitus and to explore the role of angiotensin Ⅱ blockade in the islet function repair. Methods: Seventy patients with diabetes mellitus and moderate hypertension were randomly divided into telmisartan group and amlodipine group, with 35 patients in each group. Telmisartan treatment group was given Amlodipine treatment of antihypertensive treatment; amlodipine treatment group in the control of blood glucose treatment of amlodipine for antihypertensive treatment; observation period of both groups were 12 weeks, observed once every two weeks blood pressure, fasting blood glucose, and record Hypoglycemia and other adverse reactions. HbAlc and 2-hour postprandial blood glucose were measured before and after treatment. HOMA-β and HOMA-IR were calculated according to the formula of HOMA homeostasis model. Results: Compared with amlodipine group, the insulin peak and HOMA-β in telmisartan group were significantly higher than those in the amlodipine group, while the HOMA- IR is significantly reduced. Conclusion: Telmisartan can significantly improve the islet β-cell function in patients with diabetes mellitus and hypertension, and has the effect of improving islet cell function beyond blood pressure.