Kageyama S, Yamamoto J, Mimura A, Sakurai T, Ishibashi K, Aihara K, Taniguchi I, Ito K, Isogai Y
Department of Internal Medicine (III), Jikei University School of Medicine, Tokyo, Japan.
Clin Ther. 1993 Sep-Oct;15(5):829-37.
Insulin sensitivity in terms of glucose disposal rate was measured by the hyperinsulinemic/euglycemic clamp technique in 10 hypertensive patients and 7 normotensive control subjects before and after 12 weeks of doxazosin therapy. Supine blood pressure fell significantly, from 150/98 mmHg before treatment to 136/90 mmHg after treatment (systolic P < 0.001/diastolic P < 0.01). The average dose of doxazosin at the end of the study was 3.3 +/- 0.4 mg/day. The glucose disposal rate during the last 30 minutes of the glucose clamp procedure was significantly increased, from 5.8 +/- 0.7 mg/kg/min before to 7.8 +/- 0.7 mg/kg/min after treatment (P < 0.02). Insulin sensitivity was 8.7 +/- 0.4 mg/kg/min in the normotensive subjects, which represented a significant difference when compared with that of the hypertensive subjects before treatment (P < 0.01). Steady-state serum insulin concentrations, as measured during the glucose clamp procedure, were 172 +/- 10.4 microU/ml before and 176 +/- 13.5 microU/ml after doxazosin treatment; these levels were significantly higher than the 137 +/- 7.0 microU/ml reading obtained in the normotensive subjects (P < 0.05). Study results show that hypertensive patients tend to be insulin resistant and that treatment with doxazosin improves insulin sensitivity.
采用高胰岛素-正葡萄糖钳夹技术，在10例高血压患者及7例血压正常的对照者中，于多沙唑嗪治疗12周前后测定了葡萄糖处置率来评估胰岛素敏感性。仰卧位血压显著下降，从治疗前的150/98 mmHg降至治疗后的136/90 mmHg（收缩压P<0.001/舒张压P<0.01）。研究结束时多沙唑嗪的平均剂量为3.3±0.4 mg/天。葡萄糖钳夹试验最后30分钟的葡萄糖处置率显著增加，从治疗前的5.8±0.7 mg/kg/min增至治疗后的7.8±0.7 mg/kg/min（P<0.02）。血压正常者的胰岛素敏感性为8.7±0.4 mg/kg/min，与高血压患者治疗前相比有显著差异（P<0.01）。葡萄糖钳夹试验期间测得的稳态血清胰岛素浓度，多沙唑嗪治疗前为172±10.4 μU/ml，治疗后为176±13.5 μU/ml；这些水平显著高于血压正常者测得的137±7.0 μU/ml（P<0.05）。研究结果表明，高血压患者往往存在胰岛素抵抗，多沙唑嗪治疗可改善胰岛素敏感性。
