氯沙坦与氨氯地平对肥胖高血压患者瘦素、脂联素及胰岛素敏感性比较  

Comparison of the effects of losartan and amlodipine on plasma leptin and adiponectin levels and insulin sensitivity in obese hypertensive patients

作　　者：谭庆玲[1] 陈碧玲[1] 张惠[1] 

机构地区：[1]湖北民族学院附属民大医院核医学科,湖北恩施445000

出　　处：《中国医院药学杂志》2014年第7期568-571,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的:探讨血管紧张素Ⅱ受体拮抗剂氯沙坦以及钙离子通道拮抗剂氨氯地平对肥胖高血压患者在瘦素、脂联素及胰岛素敏感性方面的影响。方法:将符合肥胖高血压要求的102病例随机按1∶1分成2组,氯沙坦组和氨氯地平组,各51例,分别单药治疗16周,于治疗前后测量所有病例的血压和体重,酶联免疫吸附法(ELISA)测定血浆瘦素及脂联素水平,稳态模型评价胰岛素抵抗指数(HOMA-IR)。结果:与治疗前相比,氯沙坦组和氨氯地平组均能安全有效地降低血压(P<0.05);此外,氯沙坦还可以降低血浆中瘦素水平、HOMA-IR和体重指数(BMI),升高血浆中脂联素水平(P<0.01);而氨氯地平则可以上调心率(P<0.01)。结论:氯沙坦和氨氯地平单药治疗肥胖高血压患者时均能安全有效地降低血压,此外,氯沙坦还能改善与肥胖相关的代谢紊乱,因此应用氯沙坦单药治疗肥胖高血压患者优势大于氨氯地平。OBJECTIVE To compare the effects of losartan and amlodipine on blood pressure, plasma levels of leptin, adipe nectin and insulin sensitivity in obese hypertensive patients. METHODS 102 patients who meet the requirements of obese hy- pertensive were divided into two groups randomly, 51 patients were treated with amlodipine besylate and another 51 patients were treated with losartan for 16 weeks. Blood pressure and body weight were examined before and after the treatment, at the same time, the levels of plasma leptin and adiponectin were determined by RIA , insulin resistance index（HOMA-IR） was eval- uated using the homeostasis model. RESULTS The blood pressure and adipocyte factors were compared before and after treat- ment, both of amlodipine besylate and losartan could reduce the blood pressure in obese hypertensive patients effectively and safely （P〈0. 05）. Plasma leptin, HOMA-IR and body mass index were significantly decreased in losartan group, plasma adiponectin was increased（P〈0. 01）, while no such changes were found in amlodipine group, but amlodipine could increase the heart rate （P〈0. 01）. CONCLUSION In obese hypertensive patients, losartan and amlodipine both have similar antihyperten- sire effect, in addition, losartan can also help to improve some obesity-related disorders. So the advantages of using losartan to cure obese hypertensive is better than using amlodipine.

关 键 词：氯沙坦 氨氯地平 肥胖症 高血压 瘦素 脂联素 胰岛素抵抗指数(HOMA-IR) 体重指数(BMI) 

分 类 号：R972.4[医药卫生—药品]