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胰岛素抵抗与高血压的研究进展

作者:杨晓虹 李晓明
出处:论文网
时间:2007-09-15


    
    3.2.3  a-糖苷酶抑制剂 
   
    其代表药物阿卡波糖,近年来的研究显示,该类药物可改善外周靶组织对胰岛素的敏感性,可阻止蔗糖诱导高血压鼠的血浆葡萄糖及胰岛素水平的升高,并可能通过尿Na+增加间接地使血压保持正常[25]。
   
    某些中药也可以改善胰岛素敏感性,尤其是黄连的主要成分盐酸小檗碱,中药金芪降糖片(含黄连)在降低血糖、改善胰岛素抵抗的同时可以明显降低果糖诱导的胰岛素抵抗高血压大鼠的血压[26]。
   
    应该注意的是高血压和代谢综合征不仅在药物治疗方面有交叉,非药物治疗方面也比较一致,高血压防治指南和对代谢综合征建议中均强调了这一点,尤其是减轻体重和适当的体力活动。
   
    胰岛素抵抗和高血压的发生均为多因素,进一步的临床研究应区分各种情况,如高胰岛素血症和低胰岛素血症。而在临床实践中对于代谢综合征高血压患者建议联合应用增加胰岛素敏感性的药物,部分病例甚至可以考虑单用。进一步的研究可能为高血压病及其他心脑血管病的全面治疗带来新的变化。
   
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