OBJECTIVE: To compare the effects of small dose of amlodipine combined with compound amiloride or telmisartan on insulin resistance in patients with primary hypertension, and to observe the change of serum resistin related with insulin resistance. METHODS: 54 patients with primary hypertension were randomly divided into 2 groups. Group A were treated with small dose of amlodipine combined with compound amiloride and group B small dose of amlodipine combined with telmisartan for 18 months. Before and after treatment, serum insulin, serum resistin and insulin resistance index (Homa-IR) were determined. RESULTS: After 18 months of treatment, FINS and Homa-IR of group A were higher than those of group B, there was significant difference (P＜0.05). FINS and Homa-IR of 2 groups were decreased after treatment, the difference of group A was not statistical significance (P＞0.05). The difference of group B was statistical significance (P＜0.05). The level of serum resistin in group A was decreased after treatment, there was no statistical significance (P＞0.05). The level of serum resistin in group B was decreased significantly (P＜0.05). The level of serum resistin in group B was significantly lower than in group A (P＜0.05). CONCLUSION:Small dose of amlodipine combined with telnisartan is better than Small dose of amlodipine combined with amiloride in the improvement of insulin resistance in patients with primary hypertension. Resistin plays important role in the formulation of insulin resistance in hypertensive patients.%目的:比较小剂量氨氯地平联合复方阿米洛利或替米沙坦对原发性高血压患者胰岛素抵抗(IR)的影响,同时观察与IR密切相关的血清抵抗素的变化.方法:选取原发性高血压患者54例,随机分为2组:A组应用小剂量氨氯地平联合复方阿米洛利,B组应用小剂量氨氯地平联合替米沙坦,2组疗程均为18个月.分别于治疗前后测定血清胰岛素、抵抗素、胰岛素抵抗指数(Homa-IR)等.结果:药物干预18个月后,A组空腹胰岛素(FINS)、Homa-IR高于B组,2组比较有统计学意义(P0.05),B组有统计学意义(P0.05),B组则较干预前显著下降(P<0.05),且显著低于A组(P<0.05).结论:小剂量氨氯地平联合替米沙坦对原发性高血压患者的IR改善作用优于联合复方阿米洛利.抵抗素在高血压患者IR的形成中起重要作用.
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