Chellingsworth M C, Kendall M J, Wright A D, Singh B M, Pasi J
Department of Pharmacology, University of Birmingham, Edgbaston, UK.
J Hum Hypertens. 1989 Feb;3(1):35-9.
The effects of one month's treatment with each of nifedipine, verapamil, diltiazem, propranolol and placebo, given in random order, on fasting plasma glucose, haemoglobin Alc, serum fructosamine, immunoreactive insulin, cholesterol, and triglyceride were studied in a group of 19 patients with hypertension and non-insulin dependent diabetes mellitus. The metabolic effects of the active drugs were generally small but fasting plasma glucose was increased by propranolol from 9.3 +/- 3.0 to 10.4 +/- 3.4 mmol/l (P less than 0.01) (mean +/- SD) and to 10.1 +/- 3.2 mmol/l (P less than 0.05) by nifedipine. Serum fructosamine was increased from 2.75 +/- 0.53 to 2.89 +/- 0.62 mmol/l (P less than 0.05) by diltiazem and to 2.91 +/- 0.65 (P less than 0.05) by propranolol. Verapamil increased fasting serum immunoreactive insulin: diltiazem and propranolol tended to reduce it. Propranolol but not the other drugs significantly increased serum triglyceride. Calcium antagonists may be preferable to beta adrenoceptor blockers for the treatment of hypertensive diabetics. Of the three calcium antagonists we studied, verapamil may have advantages over nifedipine and diltiazem.
对19例高血压合并非胰岛素依赖型糖尿病患者进行研究，以随机顺序给予硝苯地平、维拉帕米、地尔硫䓬、普萘洛尔及安慰剂，治疗1个月，观察其对空腹血糖、糖化血红蛋白、血清果糖胺、免疫反应性胰岛素、胆固醇及甘油三酯的影响。活性药物的代谢效应一般较小，但普萘洛尔使空腹血糖从9.3±3.0mmol/L升至10.4±3.4mmol/L（P<0.01）（均值±标准差），硝苯地平使其升至10.1±3.2mmol/L（P<0.05）。地尔硫䓬使血清果糖胺从2.75±0.53mmol/L升至2.89±0.62mmol/L（P<0.05），普萘洛尔使其升至2.91±0.65mmol/L（P<0.05）。维拉帕米使空腹血清免疫反应性胰岛素升高，地尔硫䓬和普萘洛尔则有降低趋势。普萘洛尔可使血清甘油三酯显著升高，而其他药物无此作用。对于高血压糖尿病患者的治疗，钙拮抗剂可能优于β肾上腺素能受体阻滞剂。在我们研究的三种钙拮抗剂中，维拉帕米可能比硝苯地平和地尔硫䓬更具优势。
