Jeng J R, Sheu W H, Jeng C Y, Huang S H, Shieh S M
Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China.
Am Heart J. 1996 Oct;132(4):783-9. doi: 10.1016/s0002-8703(96)90312-9.
The fibrinolytic and metabolic changes associated with doxazosin treatment were evaluated in 20 patients with mild to moderate hypertension. Steady-state plasma glucose (SSPG) concentration was used to subdivide hypertensive patients into two groups of 10 each: Insulin-resistant (SSPG > 190 mg/dl) and nonresistant (SSPG < 190 mg/dl). The blood pressure was normalized after 4 to 6 months of doxazosin treatment in both groups, but it was associated with significantly lower fasting plasma triglyceride level, lower integrated insulin response to a 75 gm oral glucose load, lower SSPG concentration, significant decreases in plasma plasminogen activator inhibitor type one antigen and activity and tissue plasminogen activator antigen, and a significant increase in tissue plasminogen activator activity only in the insulin-resistant group but not in the nonresistant group. It was also noted that the improvement of the fibrinolytic and metabolic abnormalities in the insulin-resistant group tended to return to the less abnormal levels seen in the non-resistant group. The data suggested that doxazosin treatment of hypertension attenuated much of the abnormalities of insulin resistance but had little effect on insulin-sensitive patients. It may support a link between impaired fibrinolysis and insulin resistance in patients with hypertension.
对20例轻至中度高血压患者评估了与多沙唑嗪治疗相关的纤溶和代谢变化。采用稳态血浆葡萄糖（SSPG）浓度将高血压患者分为两组，每组10例：胰岛素抵抗组（SSPG>190mg/dl）和非抵抗组（SSPG<190mg/dl）。两组患者在多沙唑嗪治疗4至6个月后血压均恢复正常，但同时伴有空腹血浆甘油三酯水平显著降低、对75克口服葡萄糖负荷的胰岛素综合反应降低、SSPG浓度降低、血浆纤溶酶原激活物抑制剂-1抗原和活性以及组织纤溶酶原激活物抗原显著降低，且仅胰岛素抵抗组的组织纤溶酶原激活物活性显著增加，而非抵抗组未出现此现象。还注意到，胰岛素抵抗组纤溶和代谢异常的改善倾向于恢复到非抵抗组所见的异常程度较轻的水平。数据表明，多沙唑嗪治疗高血压可减轻胰岛素抵抗的许多异常，但对胰岛素敏感患者影响不大。这可能支持高血压患者纤溶功能受损与胰岛素抵抗之间存在联系。
