Jasik M, Kasperska-Dworak A, Czyzyk A
Kliniki Gastroenterologii i Chorób Przemiany Materii AM, Warszawie.
Pol Arch Med Wewn. 1993 Jun;89(6):445-55.
In 60 patients divided in three groups, each of 10 non-diabetic patients with essential hypertension (h) and of 10 hypertensive type 2 (non-insulin-dependent) diabetics (h+c), aged 31-63 years, the effect of 2-week treatment with nifedipine, captopril and prazosin on glycaemia, serum insulin (IRI) and C peptide (CP) after oral and i.v. glucose loading was compared. Nifedipine resulted in higher glycaemia levels in the oral test in both groups. This drug caused in group (h), but not in group (h+c), reduction of the glucose-dependent early increases of serum IRI and CP, more marked in respect to CP, what was expressed by the decrease of the serum CP:IRI ratio. These results prove that in non-diabetic patients nifedipine reduces the early response of the B-cells to glucose, but this effect is partly compensated by decreased insulin uptake by the liver. In patients with type 2 diabetes this phenomenon has not become manifest because of absence or reduction of early glucose-dependent insulin release. After captopril in both groups lower values of glycaemia and serum IRI and CP were found. Prazosin did not change the determined blood parameters.
nifedipine, captopril, prazosin have a small influence on secretory function of pancreatic B-cells and may be recommended for the treatment of hypertension in patients with type 2 (non-insulin-dependent) diabetes.
将60例患者分为三组,每组10例非糖尿病原发性高血压患者(h组)和10例2型(非胰岛素依赖型)高血压糖尿病患者(h + c组),年龄在31 - 63岁之间,比较硝苯地平、卡托普利和哌唑嗪2周治疗对口服及静脉注射葡萄糖负荷后血糖、血清胰岛素(IRI)和C肽(CP)的影响。硝苯地平使两组口服试验中的血糖水平升高。该药物在h组导致血清IRI和CP的葡萄糖依赖性早期升高降低,但在h + c组未出现这种情况,CP的降低更明显,这通过血清CP:IRI比值的下降得以体现。这些结果证明,在非糖尿病患者中硝苯地平降低了B细胞对葡萄糖的早期反应,但这种作用部分被肝脏胰岛素摄取减少所补偿。在2型糖尿病患者中,由于早期葡萄糖依赖性胰岛素释放缺失或减少,这种现象未表现出来。两组使用卡托普利后,血糖、血清IRI和CP值均降低。哌唑嗪未改变所测定的血液参数。
硝苯地平、卡托普利、哌唑嗪对胰腺B细胞的分泌功能影响较小,可推荐用于2型(非胰岛素依赖型)糖尿病患者的高血压治疗。