替米沙坦对高血压病伴代谢综合征的老年患者代谢紊乱的影响  

The effect of telmisartan on glucose and lipid metabolism in old patients with hypertension and metabolic syndrome

作　　者：杨红霞[1] 米树华[1] 赵怡[1] 陶红[1] 苏工[1] 郑虹[1] 周芸[1] 赵全明[1] 王曦之[1] 李菁[1] 

机构地区：[1]首都医科大学附属北京安贞医院特需医疗科,100029

出　　处：《中国医药》2010年第4期292-294,共3页China Medicine

基　　金：北京市保健专项资金科研课题（京06-10号）

摘　　要：目的探讨替米沙坦对高血压病伴代谢综合征的老年患者代谢紊乱的影响。方法将高血压伴代谢综合征的老年患者完全随机分为替米沙坦组和硝苯地平控释片组。每组20例，分别口服替米沙坦40mg，1次／d，硝苯地平控释片30mg，1次／d，均用药6个月，观察用药前、后空腹血糖，空腹胰岛素，胰岛素抵抗指数，TG，TC，HDL—C，LDL—C等糖、脂代谢指标。结果替米沙坦组用药后血压较用药前明显降低，收缩压平均降低（21．3±12．7）mmHg（P=0．00），舒张压平均降低（12．8±1．0）mmHg（P=0．00）。硝苯地平控释片组用药后血压较用药前也明显降低，收缩压平均降低（21．5±7．8）mmHg（P=0．00），舒张压平均降低（9．0±13．1）mmHg（P=0．00）。用药6个月后，2组间比较，血压无统计学差异。替米沙坦组用药6个月后胰岛素抵抗指数较用药前明显降低[（1．83±0．68）vs（2．37±1．10），P〈0．05]，硝苯地平控释片组用药前后无统计学差异。结论替米沙坦可以改善高血压伴代谢综合征的老年患者的胰岛素抵抗。Objective To explore the effect of telmisartan on glucose and lipid metabolism in old patients with hypertension and metabolic syndrome. Methods The old patients with hypertension and metabolic syndrome were randomly divided into two groups. Each group has 20 patients. One group is orally received telmisartan 40 mg, once per day and the other is orally received nifedipine controlled release pellets 30 mg, once per day for 6 months. The level of fasting serum glucose, fasting serum insulin, insulin resistance index, TG, TC, HDL-C and LDL-C were observed. Results The decrease of patients with orally received telmisartan for 6＇months in the level of blood pressure was observed. The decrease of systolic blood pressure is averagely （21.3 ± 12.7 ） mm Hg（ p = 0.00）, The decrease of diastolic blood pressure is averagely （12.8 ± 1.0）mm Hg（ P = 0. 00）. The decrease of patients with orally received nifedipine controlled release pellets for 6 months in the level of blood pressure was observed. The decrease of systolic blood pressure is averagely （ 21.5 ± 7.8 ） mm Hg（ P = 0.00 ）, The decrease of diastolic blood pressure is averagely （9.0 ± 13.1 ）mm Hg（P =0.00）. The blood pressure was no change in two groups after 6 months. The decrease of patients with orally received telmisartan in the level of insulin resistance index was observed [ （ 1.83 ± 0. 68） vs（2.37 ± 1. 10）, P 〈 0.05 ], but there was not change in patients with nifedipine controlled release pellets. Conclusion Telmisartan can alleviate the insulin resistance in old patients with hypertension and metabolic syndrome.

关 键 词：高血压病 代谢综合征 替米沙坦 

分 类 号：R544.1[医药卫生—心血管疾病]