【摘要】 目的观察替米沙坦与苯磺酸左旋氨氯地平单独降压治疗单纯空腹血糖受损（i-IFG）高血压患者对胰岛素抵抗（IR）及相关血生化指标的影响。方法选取2015年9月—2017年1月河北省沧州市中心医院心内科收治的i-IFG高血压患者121例作为研究对象,采用随机数字表法将其分为A组（n=61,替米沙坦治疗）和B组（n=60,苯磺酸左旋氨氯地平治疗）,比较2组患者治疗前及治疗12、24个月后血压、IR、糖脂代谢指标及不良反应发生情况。结果治疗12、24个月后2组患者的收缩压（SBP）、舒张压（DBP）、空腹胰岛素（FINS）、餐后2 h胰岛素（2 h INS）、胰岛素抵抗指数（HOMA-IR）、糖化血红蛋白(HbA_1c)水平均低于治疗前（A组F=327.203、205.448、52.121、3.354、30.339、3.647,P均<0.01;B组F=187.935、210.062、13.428、3.209、12.323、3.871,P均<0.01）,高密度脂蛋白胆固醇（HDL-C）高于治疗前（F=3.971、3.720,P<0.01）,而空腹血糖（FPG）、餐后2 h血糖（2 h PG）、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）水平与治疗前比较差异无统计学意义（P>0.05）,且治疗12个月后,A组SBP、FINS、2 h INS、HOMA-IR较B组改善更显著（P<0.05）,治疗24个月后,2组比较差异无统计学意义（P>0.05）。2组进展为糖尿病的发生率及不良反应发生率比较差异均无统计学意义（P>0.05）。结论替米沙坦和苯磺酸左旋氨氯地平均可有效降低i-IFG高血压患者血压,改善患者的IR,防止糖尿病的发生发展,且替米沙坦在短时间内改善患者SBP、IR的效果更显著。更多还原

【Abstract】 Objective To observe the effects of telmisartan and levamlodipine besylate alone on insulin resistance（IR）and related blood biochemical indexes in patients with simple impaired fasting blood glucose（i-IFG）hypertension.Methods One hundred and twenty-one patients with i-IFG hypertension admitted to the Department of Cardiology,Cangzhou Central Hospital of Hebei Province from September 2015 to January 2017 was selected as the study subjects.They were divided into group A（n=61,telmisartan treatment）and group B（n = 60,Levamlodipine besylate treatment）by random number table method.The blood samples of the two groups were compared before treatment and 12,24 months after treatment.Pressure,IR,glycolipid metabolism and adverse reactions.Results Systolic blood pre.ssure（SBP）,diastolic blood pressure（DBP）,fasting insulin（FINS）,2 h postprandial insulin（2 h INS）,insulin resistance index（HOMA-IR）,glycosylated hemoglobin(HbA_{1 c}),high density lipoprotein cholesterol（HDL-C）levels in the two groups after 12 and 24 months of treatment were lower than those before treatment（Group A:F = 327.203,205.448,52.121,3.354,30.339,3.647,5.430,P<0.01;Group B:F= 187.935,210.062,13.428,3.209,12.323,3.871,9.782,P<0.01）,while the levels of fasting blood sugar（FPG）,2-hour postprandial blood sugar（2 h PG）,triglyceride（TG）,total cholesterol（TC）,low-density lipoprotein cholesterol（LDL-C）had no significant difference before and after treatment（P>0.05）.After 12 months,SBP,FINS,2 h INS and HOMA-IR in group A improved more significantly than those in group B（P<0.05）.After 24 months of treatment,there was no significant difference between the two groups（P>0.05）.There was no significant difference in the incidence of diabetes mellitus and adverse reactions between the two groups（P>0.05）.Conclusion Both telmisartan and Levamlodipine besylate can effectively reduce blood pressure,improve IR and prevent diabetes mellitus in patients with I IFG hypertension,and telmisartan can improve SBP and IR in a short time.更多还原