Rett K, Wicklmayr M, Tschollar W, Dietze G, Mehnert H
III. Medical Department, Schwabing Hospital, Munich, FRG.
Postgrad Med J. 1988;64 Suppl 3:69-74; discussion 90-2.
The effect of captopril monotherapy on blood pressure and metabolism was investigated in a placebo-controlled study in 30 non-insulin dependent (Type II) diabetic subjects during a 3-week observation period (run-in/drug; placebo/wash-out) on a metabolic ward. Captopril significantly reduced both systolic and diastolic blood pressure (154/90 +/- 5/2 vs. 144/86 +/- 4/3 mmHg) without major side effects. Mean run-in postprandial blood glucose concentrations were also reduced upon ACE-inhibition (9 a.m.: 12.7 +/- 0.4 vs. 11.1 +/- 0.4 mmol/l; 1 p.m.: 11.0 +/- 0.3 vs. 8.9 +/- 0.3 mmol/l; P less than 0.05), while blood kinin concentrations (40.0 +/- 2.5 pmol/l) were approximately doubled (108.8 +/- 23.5 pmol/l; P less than 0.05). Body mass index, fasting plasma insulin, serum electrolyte pattern, uric acid, white blood count, lipid profile as well as hepatic and renal function parameters remained unaltered throughout the observation period. The data are in line with recent experimental studies showing a beneficial metabolic effect of captopril in Type II diabetes. ACE inhibitors might therefore become first-line drugs in early antihypertensive intervention in Type II diabetic patients.
在一家代谢病房进行的一项安慰剂对照研究中，对30名非胰岛素依赖型（II型）糖尿病患者在为期3周的观察期（导入期/用药期；安慰剂/洗脱期）内，研究了卡托普利单一疗法对血压和代谢的影响。卡托普利显著降低了收缩压和舒张压（154/90±5/2与144/86±4/3 mmHg），且无主要副作用。血管紧张素转换酶抑制后，平均导入期餐后血糖浓度也有所降低（上午9点：12.7±0.4与11.1±0.4 mmol/L；下午1点：11.0±0.3与8.9±0.3 mmol/L；P<0.05），而血激肽浓度（40.0±2.5 pmol/L）大约增加了一倍（108.8±23.5 pmol/L；P<0.05）。在整个观察期内，体重指数、空腹血浆胰岛素、血清电解质模式、尿酸、白细胞计数、血脂谱以及肝肾功能参数均未改变。这些数据与最近的实验研究一致，表明卡托普利对II型糖尿病具有有益的代谢作用。因此，血管紧张素转换酶抑制剂可能会成为II型糖尿病患者早期抗高血压干预的一线药物。
