论文部分内容阅读
目的:探讨卡维地洛对高血压合并糖尿病患者血管内皮功能及胰岛素抵抗的影响。方法:经2周导入期后熏将41例高血压合并2型糖尿病患者熏随机分为卡维地洛组(21例)和美托洛尔组(20例)。治疗前及治疗6月后熏采静脉血测定空腹胰岛素、空腹血糖熏计算胰岛素敏感性指数;采用高分辨率超声检测反应性充血和硝酸甘油介导的肱动脉舒张功能。结果:卡维地洛治疗6月后,患者收缩压和舒张压均有效下降熏空腹胰岛素降低,胰岛素敏感指数显著升高熏反应性充血和硝酸甘油介导的血管舒张功能均明显改善。美托洛尔治疗后,空腹血糖和空腹胰岛素均轻度升高,胰岛素敏感指数降低,但差异均不具有统计学意义;反应性充血和硝酸甘油介导的血管舒张功能均无明显变化。结论:卡维地洛可有效降低高血压合并2型糖尿病患者的血压,改善胰岛素抵抗及肱动脉内皮依赖性及非内皮依赖性的血管舒张功能。
Objective: To investigate the effect of carvedilol on vascular endothelial function and insulin resistance in patients with hypertension and diabetes mellitus. Methods: Forty-one patients with hypertension and type 2 diabetes were randomly divided into 2 groups: carvedilol group (21 cases) and metoprolol group (20 cases). Fasting insulin and fasting blood glucose were measured before treatment and 6 months after treatment. Insulin sensitivity index was calculated. High-resolution ultrasound was used to detect reactive hyperemia and nitroglycerin-mediated brachial artery diastolic function. Results: After 6 weeks of carvedilol treatment, systolic and diastolic blood pressure of patients decreased significantly and fasting insulin decreased, and insulin sensitivity index increased significantly. Smoked reactive hyperemia and nitroglycerin-mediated vasodilation were significantly improved. Metoprolol treatment, fasting blood glucose and fasting insulin were slightly increased, insulin sensitivity index decreased, but the difference was not statistically significant; reactive hyperemia and nitroglycerin-mediated vasodilation were no significant changes. CONCLUSION: Carvedilol can effectively reduce the blood pressure and improve the insulin resistance and the endothelium-dependent and endothelium-independent vasodilatation in hypertensive patients with type 2 diabetes mellitus.