罗格列酮治疗肥胖型原发性高血压的疗效观察  

Efficacy observation of rosiglitazone in treatment of obese primary hypertension

作　　者：陈清波[1] 杨永霞[2] 

机构地区：[1]贵州省湄潭县人民医院内一科,贵州湄潭564199 [2]贵州省湄潭县人民医院麻醉科,贵州湄潭564199

出　　处：《中国现代医生》2015年第28期22-24,共3页China Modern Doctor

摘　　要：目的观察盐酸罗格列酮在肥胖的轻、中度原发性高血压患者中的降压作用,探讨罗格列酮用于肥胖型原发性高血压治疗和(或)辅助治疗的可能性。方法收集我院2014年3~12月心内科门诊的肥胖型(体重指数>25 kg/m^2)非糖尿病、排除慢性心功能不全的轻、中度原发性高血压[140 mmHg<收缩压<180 mmHg]患者42例(测定空腹血糖<5.6 mmol/L、餐后2 h血糖<11.1 mmol/L及糖化血红蛋白<7%,排除糖尿病,心脏超声测定LVEF>40%,排除心衰)。原服有降压药者停药2周后进入实验,原生活方式不变,只服用盐酸罗格列酮4 mg,2次/d,疗程4周。分析血压下降情况。结果(1)治疗4周后低危组收缩压平均降低(12.8±0.8)mmHg,舒张压平均降低(8.6±0.6)mmHg;高危组收缩压平均降低(14.2±1.2)mmHg,舒张压平均降低(8.2±0.8)mmHg。(2)血压基线水平、体重指数高的高危组患者治疗后与治疗前比较糖化血红蛋白、餐后2 h血糖下降率分别为16.8%、20.0%、21.0%、25.0%。(3)在基线血压水平较高、肥胖指数越大及有高血压家族史的患者其降压幅度更大。结论罗格列酮对肥胖的轻、中度高血压患者显示了良好的降压效能,其降压效果与胰岛素抵抗程度呈正相关,在治疗期间并未增加外周水钠潴留而导致心衰的发生。Objective To observe the antihypertensive effect of rosiglitazone hydrochloride on the obese patients with mild and moderate primary hypertension and explore the possibility of applying rosiglitazone to the treatment and （or） the adjuvant treatment of obese primary hypertension. Methods Forty-two patients with mild and moderate hyperten- sion [140 mmHg〈SBP〈180 mmHg] and obese （BMI〉25 kg/m2） non-diabetes and without chronic cardiac insufficiency in the cardiological outpatient department of our hospital from March to December 2014 were collected （Diabetes was ex- cluded if fasting blood glucose 〈5.6 mmol/L, 2-hour postprandial blood glucose 〈11.1 mmol/L and glycosylated hemoglobin〈7%, and heart failure was excluded if heart ultrasound measured LVEF〉40%）. The patients who used to take antihypertensive drugs were allowed in the experiment after 2 weeks of drug withdrawal and their life style did not change; They only took 4 mg of rosiglitazone maleate twice/day and the treatment course was 4 weeks. The drop of blood pressure was analyzed. Results （1） After 4 weeks of treatment, in the low risk group, the mean systolic pressure decreased by （12.8±0.8） mmHg and the mean diastolic pressure decreased by （8.6±0.6） mmHg, and in the high risk group, the mean systolic pressure decreased by （14.2±1.2） mmHg and the mean diastolic pressure decreased by （8.2±0.8） mmHg. （2） For the patients in the high risk group with high blood pressure baseline level and body mass index, the glycated hemoglobin and 2-hour postprandial blood glucose after treatment decreased by 16.8% and 20.0%, and 21.0% and 25.0%. （3） For the patients with higher blood pressure baseline level, larger obesity index and hypertension family history, the depressurizing range was larger. Conclusion Rosiglitazone shows good depressurizing effect on the obese patients with mild and moderate hypertension, which is positively correlated to the insulin resistance degree, and does not in- crease the occurrence of

关 键 词：胰岛素增敏剂 罗格列酮 肥胖 高血压 

分 类 号：R587.1[医药卫生—内分泌]