氯沙坦对肥胖高血压患者肥胖相关代谢紊乱状况的影响  

Effect of Iosartan on obesity related metabolic disorder in obese and hypertensive patients

作　　者：倪月珠 戎立辉 

机构地区：[1]宁波市北仑区小港医院药剂科,浙江省宁波315800 [2]慈溪市第三人民医院内科,浙江省慈溪315000

出　　处：《中国基层医药》2017年第23期3594-3598,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 分析氯沙坦与氨氯地平对肥胖高血压患者的瘦素、脂联素及胰岛素敏感性方面的影响.方法 选择肥胖高血压患者126例,按照随机数字表法分为氯沙坦组和氨氯地平组,每组63例.氯沙坦组患者应用氯沙坦50 mg/次,1次/d,氨氯地平组应用氨氯地平50 mg/次,1次/d.两组单独给予对应药物16周,检测分析两组患者治疗前后体重指数（BMI）、心率、收缩压、舒张压、瘦素、脂联素、胰岛素抵抗指数（HOMA-IR）、去甲肾上腺素水平.结果 氯沙坦组治疗后BMI显著降低,差异有统计学意义（t=6.660,P＜0.05）,而心率差异无统计学意义（t=0.180,P＞0.05）;氨氯地平组治疗后BMI明显降低（t=3.647,P＜0.05）,心率明显增加,差异有统计学意义（t=3.098,P＜0.05）.治疗后,氯沙坦组患者的BMI水平和心率明显低于氨氯地平组,两组差异有统计学意义（t=3.106、3.256,P＜0.05）.两组治疗后收缩压和舒张压均显著降低,差异有统计学意义（t氯沙坦组=9.503、13.095;t氨氯地平组=10.254、11.776,P＜0.05）,组间差异无统计学意义（t=0.975、0.659,P＞0.05）.氯沙坦组治疗后脂联素水平显著增高,瘦素水平及HOMA-IR评分显著降低,差异均有统计学意义（t=4.462、2.004、5.572,均P＜0.05）,NE水平差异无统计学意义（t=0.481,P＞0.05）;氨氯地平组治疗后NE水平显著增高,差异有统计学意义（t=6.090,P＜0.05）,瘦素水平、脂联素及HOMA-IR评分水平差异均无统计学意义（=0.126、0.053、0.448,均P＞0.05）.结论 氯沙坦和氨氯地平均可有效控制高血压,但氯沙坦可有效调节肥胖相关的代谢紊乱,因此,肥胖高血压患者单独服用氯沙坦比单独服用氨氯地平效果更显著.Objective To analyze the effects of losartan and amlodipine on leptin,adiponectin and insulin sensitivity in obese hypertensive patients.Methods 126 patients with obesity related hypertension were selected,and they were randomly divided into losartan group and amlodipine group according to the digital table,63 cases in each group.The losartan group were treated with losartan 50mg/time,1 time/d.The amlodipine group was given amlodipine 50mg/time,1 time/d.The two groups were given the corresponding drugs for 16 weeks.The body mass index （BMI）,heart rate,systolic blood pressure （SBP）,diastolic blood pressure （DBP）,leptin,adiponectin,HOMA-IR and norepinephrine（NE） levels were measured before and after treatment in the two groups.Results After treatment,the BMI of the losartan group decreased significantly,the difference was statistically significant （t =6.660,P 〈 0.05）,but there was no significant difference in heart rate （t =0.180,P 〉0.05）.After treatment,the BMI of the amlodipine group decreased significantly （t =3.647,P 〈 0.05）,heart rate increased significantly,the difference was statistically significant （t =3.098,P 〈 0.05）.After treatment,the BMI and heart rate in the losartan group were significantly lower than those in the amlodipine group,and the differences between the two groups were statistically significant （t =3.106,3.256,all P 〈0.05）.After treatment,the SBP and DBP in the two groups were significantly decreased,the differences were statistically significant （tlosartan group =9.503,13.095;tamlodipine group =10.254,11.776,all P 〈 0.05）,there were no statistically significant differences between the two groups （t =0.975,0.659,all P 〉 0.05）.After treatment,the level of adiponectin in the losartan group was significantly increased,the leptin level and HOMA-IR score decreased significantly,the differences were statistically significant （t =4.462,2.004,5.572,all P 〈 0.05）,there was no significant difference in the level of NE （t =0.481,P 〉 0.

关 键 词：高血压 肥胖症 氯沙坦 氨氯地平 

分 类 号：R544.1[医药卫生—心血管疾病]