摘要
目的观察胰岛素增敏剂罗格列酮对老年2型糖尿病患者的降压作用及其对血管内皮的保护作用。方法将104例无高血压史（未服用降压相关药物）的老年2型糖尿病患者按初诊收缩压（SBP）分为3组，理想血压组（SBP≤120mmHg，1mmHg=0．133kPa）42例，前期高血压组（140mmHg≥SBP〉120mmHg）33例，轻度高血压组（160mmHg≥SBP〉140mmHg）29例。维持原治疗不变，应用罗格列酮4mg／d，治疗12周。测定治疗前、后SBP、舒张压（DBP）、空腹血糖（FBG）、糖化血红蛋白（Hb）A1c、稳态模型评估-胰岛素抵抗指数（HOMA—IR）、总胆固醇（TC）、低密度脂蛋白（LDL）、vWF、白细胞（WBC）计数、C反应蛋白（CRP）、非对称性二甲基精氨酸（ADMA）水平。结果用药12周后，轻度高血压组治疗后SBP及DBP均较治疗前有所下降，差异有统计学意义（P〈0．05）。前期高血压组治疗后SBP下降，有统计学意义（P〈0．05），而DBP虽下降，但无统计学意义。3组FBG、HbA1c、HOMA—IR、TC、LDL较治疗前下降，差异有统计学意义（P〈0．05）。另外，治疗后vWF、WBC及CRP也较治疗前下降，差异有统计学意义（P〈0．05）。结论罗格列酮可以降低老年2型糖尿病患者的SBP及DBP，对于基础血压高者降压效果更为显著，同时还可改善内皮细胞功能，发挥保护内皮的作用。
Objective To investigate the endothelial function-protecting and blood pressure-lowering effects of rosiglitazone in elderly patients with type 2 diabetes mellitus. Methods 104 cases of elderly patients with type 2 diabetes without history of hypertension were enrolled in this study. According to their first office blood pressure, they were divided into three groups： 42 patients of normal blood pressure（ SBP ≤ 120 mm Hg, 1 mm Hg = 0. 133 kPa） ,33 cases of prehypertension （140 mm Hg≥ SBP 〉 120 mm Hg）and 29 cases of hypertension （ 160 mm Hg≥ SBP 〉 140 mm Hg）. At baseline and after treatment with 12 weeks of rosiglitazone （4 mg/d）,we measured metabolic parameters such as SBP,DBP,FBG,HbAlc, HOMA-IR,TC, LDL,vWF,WBC,CRP and ADMA. Results After 12 weeks treatment with rosiglitazone,the mean of SBP and DBP were reduced in hypertension group, the mean SBP was reduced in prehypertension group, respectively （ P 〈 0.05 ）. Moreover, FBG, HbA1 c, HOMA-IR,TC and LDL in 3 groups were decreased （ P 〈 0.05 ）, compared with baseline. The levels of vWF and WBC were also decreased （ P 〈 0. 05 ）. Conclusions Rosiglitazone significantly decreases blood pressure in elderly patients with type 2 diabetes. Rosiglitazone not only ameliorates insulin resistance but also improves endothelial function and chronic inflammation.
出处
《国际内分泌代谢杂志》
2009年第4期244-247,共4页
International Journal of Endocrinology and Metabolism
关键词
罗格列酮
2型糖尿病
血压
胰岛素抵抗
内皮功能
Rosiglitazone
Type 2 diabetes mellitus
Blood pressure
Insulin resistance
Endothelial function
