多沙唑嗪与特拉唑嗪对老年高血压病患者糖脂代谢的影响  

The effect of doxazosin and terazosin on glucose and lipid metabolism in old hypertensive patients

作　　者：谢蒂立[1] 金静[1] 钟萍[1] 

机构地区：[1]四川省医学科学院.四川省人民医院老年心内科,四川成都610072

出　　处：《实用医院临床杂志》2016年第1期53-55,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨多沙唑嗪与特拉唑嗪对老年原发性高血压患者血脂代谢、胰岛素抵抗及动脉粥样硬化的影响。方法选取老年原发性高血压合并良性前列腺增生患者66例,按简单随机法分为多沙唑嗪组(34例)及特拉唑嗪组(32例),多沙唑嗪组患者睡前口服甲磺酸多沙唑嗪控释片4 mg qn,特拉唑嗪组患者睡前口服盐酸特拉唑嗪片2 mg qn。治疗12周,比较两组治疗前后及两组间治疗后糖脂代谢指标、颈动脉内膜中层厚度(IMT)与颈动脉粥样硬化斑块Crouse积分。结果两组治疗后TC、TG、LDL-C、IMT及颈动脉粥样硬化斑块Crouse积分均较治疗前下降,且多沙唑嗪组低于特拉唑嗪组,差异有统计学意义(P<0.05)。多沙唑嗪组治疗后空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(HOMA-IS)改善,与治疗前比较差异有统计学意义(P<0.05),而特拉唑嗪组治疗前后的差异无统计学意义(P>0.05)。结论老年原发性高血压患者使用多沙唑嗪在改善糖脂代谢及抗动脉粥样硬化方面均优于特拉唑嗪。Objective To investigate the effects of doxazosin and terazosin on blood lipid metabolism, insulin resistance and atherosclerosis in old hypertensive patients. Methods Sixty-eight old patients （age 〉80 years old）with essential hypertension combined with benign prostatic hyperplasia （BPH）were randomly divided into doxazosin group （n = 34 ）or terazosin group （n = 32）. In the doxazosin group, patients were prescribed to take one doxazosin mesylate extended-release tablet （4 mg qn）while in the terazosin group was prescribed to take one terazosin hydrochloride （2 mg qn）. The treatment course was 12 weeks. The levels of total cholesterol （ TC）, low density lipoprotein cholesterol （ LDL-C ）, triglyceride （ TG）, fasting blood glucose, fasting insulin, HOMA-IR, HOMA-IS, carotid intima-media thickness （IMT） ,the Grouse plaque score of carotid atherosclerotic plaque were compared before and after treatments in the both groups and between the two groups. Results After treatment, TC, TG, LDL-C, IMT and Crouse score were all decreased when compared to before treatment, and the decreased degree in the doxazosin group was lower than that in the terazosin group （P 〈 0. 05）. In the doxazosin group, the indicators of FPG, FINS, HOMA-IR and HOMA-IS were improved after treatment when compared to before treatment （P 〈 0. 05）. However,differences in these indicators in the terazosin group were not statistically significant before and after treatment （P 〉 0. 05）. Conclusion For elderly hypertensive patients, doxazosin has a better effect on the glucose-lip- id metabolism and atherosclerosis than terazosin does.

关 键 词：多沙唑嗪 特拉唑嗪 血脂代谢 胰岛素抵抗 动脉粥样硬化 

分 类 号：R972.4[医药卫生—药品]