替米沙坦对肥胖高血压患者胰岛素敏感性及血清高敏C反应蛋白的影响  

Effects of telmisartan on insulin resistance and high sensitivity C-reactive protein in obese patients with essential hypertension

作　　者：张莉[1] 黄高忠[1] 张蓓[1] 胡廷军[1] 钟远[1] 

机构地区：[1]上海交通大学附属第六人民医院老年科,上海市200233

出　　处：《中华实用诊断与治疗杂志》2010年第12期1170-1172,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：上海交通大学医学院科技基金项目(06XJ21107)

摘　　要：目的:探讨替米沙坦对肥胖高血压患者血压、糖脂代谢指标和血清脂联素、高敏C反应蛋白的影响及其机制。方法:选取23例超体质量或肥胖的原发性高血压患者,给予替米沙坦40 mg,1次/d,2周后增至80 mg,1次/d,每2周随访1次,记录心率、血压、体质量,必要时加用长效钙拮抗剂,治疗16周。观察用药前、后患者腰围、腰臀比、体质量指数、血压、空腹血糖、胰岛素、血脂和血清脂联素及高敏C反应蛋白的变化。采用稳态模式法计算胰岛素抵抗指数。结果:与治疗前比较,治疗后患者收缩压、舒张压及胰岛素抵抗指数均明显下降(P<0.01),血清脂联素升高(P<0.01),高敏C反应蛋白水平降低(P<0.05)。结论:替米沙坦可改善肥胖伴高血压患者的胰岛素敏感性,升高血清脂联素水平、降低高敏C反应蛋白水平。Objective To investigate the effects of telmisartan on blood pressure,glycometabolism and lipid metabolism indexes,adiponectin and high sensitivity C-reactive protein in obese patients with essential hypertension and its mechanism.Methods Twenty-three obese patients with essential hypertension were treated with telmisartan 80 mg/d once a day after two-week treating with 40 mg/d once a day.The waist circumference,waist-to-hip ratio,body mass index,blood pressure,fasting plasma glucose and insulin,lipid,adiponectin and high sensitivity C-reactive protein were measured before and after the treatment.Insulin resistance index was estimated with homeostasis model assessment.Results Compared with the baseline levels,the systolic and diastolic blood pressure and the levels of insulin resistance index decreased significantly,the adiponectin level increased（P0.05） and high sensitivity C-reactive protein level decreased（P0.05）.Conclusion Telmisartan can improve insulin sensitivity,increase the adiponectin level and decrease high sensitivity C-reactive protein level.

关 键 词：高血压 胰岛素抵抗 替米沙坦 脂联素 高敏C反应蛋白 

分 类 号：R544.1[医药卫生—心血管疾病]