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目的探讨替米沙坦对高血压病伴糖耐量减低(IGT)的治疗效果。方法应用替米沙坦治疗高血压病合并糖耐量减低46例,监测治疗前及治疗12周后收缩压、舒张压,抽取空腹及口服75g葡萄糖2h后静脉血,检测空腹血糖(FPG)、餐后2h血糖(2hPG)、空腹胰岛素(FINS)、餐后2h胰岛素(2h INS),用氧化酶法测血糖,血清胰岛素测定用放射免疫分析法。结果替米沙坦治疗前后血压分别为(161±14)/(98±8)mm Hg(1mm Hg=0.133kPa)和(132±13)/(94±8)mm Hg,治疗后收缩压、舒张压较治疗前明显下降,差异有统计学意义(P<0.05);治疗12周后,除FPG外,2hPG、FINS、2hINS均有显著下降(P<0.05),胰岛素敏感性指数(ISI)升高(P<0.05),差异有统计学意义。治疗前后肾功能、血钾、血脂比较各指标治疗前后差异无统计学意义(P>0.05)。结论替米沙坦在具有显著降压作用的同时,能改善高血压病的胰岛素抵抗,提高葡萄糖的利用率,有效地改善IGT。治疗过程中未见咳嗽等不良反应,耐受性好,对脂代谢无显著影响,可作为高血压病伴IGT的首选治疗药物。
Objective To investigate the therapeutic effect of telmisartan on hypertension with impaired glucose tolerance (IGT). Methods 46 cases of hypertension with impaired glucose tolerance were treated with telmisartan. Systolic blood pressure and diastolic blood pressure were measured before and 12 weeks after treatment. Venous blood was collected 2 hours after fasting and oral glucose administration. FPG, Blood glucose (2hPG), fasting insulin (FINS) and 2h insulin (2h INS) were measured after 2h, and blood glucose was measured by oxidase method. Serum insulin was measured by radioimmunoassay. Results Before and after telmisartan treatment, blood pressure was (161 ± 14) / (98 ± 8) mm Hg (1 mm Hg = 0.133 kPa) and (132 ± 13) / (94 ± 8) mm Hg, The diastolic blood pressure was significantly lower than that before treatment (P <0.05). After 12 weeks of treatment, except for FPG, 2hPG, FINS and 2hINS decreased significantly (P <0.05) and insulin sensitivity index (ISI) (P <0.05), the difference was statistically significant. Before and after treatment of renal function, serum potassium, blood lipids compared before and after treatment, there was no significant difference (P> 0.05). Conclusion Telmisartan can reduce the insulin resistance of hypertensive patients, improve the utilization of glucose and improve the IGT effectively. No adverse reactions such as cough were found in the course of treatment, and the drug was well tolerated and had no significant effect on lipid metabolism. It could be used as the first choice of treatment for hypertension with IGT.