替米沙坦对2 型糖尿病合并高血压患者胰岛β 细胞功能影响 的临床观察

目的:观察替米沙坦对糖尿病合并高血压患者胰岛β细胞功能的影响,探索血管紧张素Ⅱ阻断剂降压以外的胰岛功能修复作用.方法:70例糖尿病合并轻、中度高血压的患者随机分为替米沙坦治疗组和氨氯地平治疗组,每组35例患者；替米沙坦治疗组在控制血糖的治疗上给予替米沙坦进行降压治疗；氨氯地平治疗组在控制血糖的治疗上给予氨氯地平进行降压治疗；两组的观察周期均12周,每2周观察1次血压、空腹血糖、并记录低血糖及其它不良反应.治疗前后测糖化血红蛋白(HbAlc)、餐后2小时血糖,并按照HOMA稳态模型公式计算胰岛β细胞功能指数(HOMA-β)和胰岛素抵抗指数(HOMA-IR).结果:两组患者在降压效果方面无显著性差异,收缩压、舒张压对比,P＞0.05;与氨氯地平组比较,替米沙坦组胰岛素峰值和HOMA-3显著升高,HOMA-IR则显著降低.结论:替米沙坦可更显著改善糖尿病合并高血压的患者的胰岛β细胞功能,具有降压以外的改善胰岛细胞功能的作用.

The Effects of Telmisartan to the Function of Beta Cell of Islet in Human New Diagnosis of Type 2 Diabetes and Hypertension

Objective:To investigate the effects of Telmisartan to the beta cell of islet in people diagnosis with type 2 diabetes combine hypertension.Methods:70 people diagnosis with diabetes and combine mild to moderate hypertension people were divided into two groups:the telmisartan group and the amlodipine group,35 people in each group.The base control blood glucose were given in both of the groups,in telmisartan group the telmisartan were given to control the blood pressure;the amlodipine group the amlodipine were given to control the blood pressure.The blood pressure and fasting blood glucose were observed in two weeks.The observation time is 12 weeks,before and after observation time,the HbAlc,insulin levels,glucose level after two hours after glucose challenge were detected.Calculated steady-state model according to HOMA β-cell function index(HOMA-β) and insulin resistance index(HOMA-IR).Results:In lower the blood pressure,there were no significantly difference between the two groups,including the SBP and DBP,P>0.05.Compared to the amlodipine group,the telmisartan improved the insulin secretion and the HOMA-βbut decreased the HOMA-IR.Conclusions:Telmisartan may make more significant improvement in patients with diabetes and high blood pressure β-cell function,with improvement in blood pressure as well as the function of islet cells.