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目的研究胰岛素增敏剂-盐酸吡格列酮对代谢综合征(MS)并高血压患者高胰岛素血症的治疗效果,以及随着高胰岛素血症的纠正,血压、血糖、血脂的变化情况。并通过测定超敏C反应蛋白(hs-CRP)含量了解心血管事件发生危险性是否下降。方法将于2006年10月至2007年8月于我院确诊为代谢综合征并高血压的患者63例,随机分为两组,治疗组31例,给予贝那普利+盐酸吡格列酮,对照组32例给予贝那普利+二甲双胍。治疗前及治疗3个月后分别测定血压、糖耐量试验、胰岛素释放试验、血脂、hs-CRP。结果两组患者治疗前后血压均有明显下降,治疗组收缩压下降13mmHg(1mmHg=0·133kPa),舒张压下降10mmHg,平均动脉压下降11mmHg,下降幅度超过对照组,P<0·01;两组血糖、胰岛素水平、hs-CRP均有显著下降,达到统计学差异,其中治疗组比对照组下降更明显,P<0·01;血脂方面治疗组中TG、LDL-C下降,HDL-C有升高,达到差异有统计学意义,P<0·05,而对照组中均未达到统计学明显差异。结论盐酸吡格列酮在改善胰岛素抵抗、降低血压、调节糖、脂代谢、降低心血管事件发生率方面有着比二甲双胍更强的治疗效果。
Objective To study the effect of insulin sensitizer - pioglitazone on hyperinsulinemia in patients with metabolic syndrome (MS) and hypertension, and the changes of blood pressure, blood glucose and blood lipids with the correction of hyperinsulinemia. And by measuring the content of hs-CRP, we know if the risk of cardiovascular events is declining. Methods Sixty-three patients with metabolic syndrome and hypertension diagnosed in our hospital from October 2006 to August 2007 were randomly divided into two groups: treatment group (31 cases), benazepril hydrochloride plus pioglitazone hydrochloride group, control group 32 cases given benazepril + metformin. Blood pressure, glucose tolerance test, insulin release test, blood lipid, hs-CRP were measured before treatment and 3 months after treatment. Results Before and after treatment, blood pressure decreased significantly in both groups. Systolic blood pressure decreased by 13mmHg (1mmHg = 0.133kPa), diastolic blood pressure decreased by 10mmHg, and mean arterial pressure decreased by 11mmHg in treatment group, which decreased by more than that of control group (P <0.01) Blood glucose, insulin levels, hs-CRP were significantly decreased, reaching statistical differences, the treatment group than the control group decreased more significantly, P <0.01; lipids in the treatment group TG, LDL-C decreased HDL-C There was a statistically significant difference between the two groups (P <0.05), but no significant difference was found in the control group. Conclusion Pioglitazone has a stronger therapeutic effect than metformin in improving insulin resistance, lowering blood pressure, regulating glucose and lipid metabolism, and reducing the incidence of cardiovascular events.