氯沙坦与厄贝沙坦对女性高血压伴高尿酸血症患者血压、胰岛素敏感指数的影响  

Effect of losartan and irbesartan on blood pressure and ISI in female hypertension patients complicated with hyperuricemia

作　　者：韩建勤 徐烨华 罗萍 李继东 何丽娟 马丽 王习韫 汪晓洲 Han Jianqin;Xu Yehua;Luo Ping;Li Jidong;He Lijuan;Ma Li;Wang Xiyun;Wang Xiaozhou(Department of Cardiology,the Third People's Hospital of Ningxia Hui Autonomous Region,Yinchuan,Ningxia 750011,China;Department of Hypertension,Cardio-Cerebrovascular Disease Specialist Hospital of Qinghai Province,Xining,Qinghai 810012,China)

机构地区：[1]宁夏回族自治区第三人民医院心血管内科,银川750011 [2]青海省心脑血管病专科医院高血压科,西宁810012

出　　处：《中国基层医药》2019年第5期518-522,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：宁夏回族自治区卫生计生委重点科研计划课题(2015-NW-046).

摘　　要：目的比较氯沙坦与厄贝沙坦对女性高血压伴高尿酸血症患者血压、血尿酸、胰岛素敏感性、胰岛素抵抗的影响。方法选取2015年8月至2017年12月在宁夏回族自治区第三人民医院治疗的女性高血压伴高尿酸血症患者100例。采用随机数字表法分成两组,观察组(n=50)采用氯沙坦钾治疗,对照组(n=50)采用厄贝沙坦治疗,两组疗程均为8周。比较两组总有效率和不良反应发生情况,比较两组治疗前后血压、血尿酸、空腹血糖(FBG)、空腹胰岛素(FINS)、高敏C反应蛋白(hs-CRP)、胰岛素敏感指数(ISI)和胰岛素抵抗指数(HOMA-IR)的变化。结果观察组与对照组总有效率[92.0%(46/50)比90.0%(45/50)]差异无统计学意义(P>0.05)。治疗前,两组血压、血尿酸、FBG、FINS、hs-CRP、ISI和HOMA-IR差异均无统计学意义(均P>0.05)。治疗后,观察组收缩压、舒张压分别为(133.09±10.11)mmHg、(82.76±6.23)mmHg,对照组分别为(131.54±11.01)mmHg、(83.75±6.88)mmHg,两组均比治疗前明显降低(观察组:t=19.742、10.606,对照组:t=18.925、-9.956,均P<0.05),组间差异均无统计学意义(均P>0.05);观察组血尿酸[(387.21±25.56)μmol/L]明显低于对照组[(429.67±27.44)μmol/L],差异有统计学意义(t=8.006,P<0.05);观察组hs-CRP、FINS、HOMA-IR、ISI分别为(4.92±1.02)mg/L、(15.92±3.01)mU/L、(1.71±0.24)、(1.047±0.095),对照组分别为(4.54±1.00)mg/L、(17.23±3.20)mU/L、(1.65±0.27)、(1.140±0.083),两组hs-CRP、FINS、HOMA-IR均降低,ISI均升高,且观察组FINS、ISI和HOMA-IR改善情况明显优于对照组,差异均有统计学意义(t=2.109、-5.213、3.191,均P<0.05)。结论氯沙坦与厄贝沙坦治疗女性高血压伴高尿酸血症患者,均可有效改善临床症状,降低患者血压,改善患者胰岛素抵抗,两者相比氯沙坦的治疗效果更为显著。Objective To compare the effects of losartan and irbesartan on blood pressure, blood uric acid, insulin sensitivity and insulin resistance in female hypertensive patients complicated with hyperuricemia. Methods From August 2015 to December 2017, 100 females of hypertension complicated with hyperuricemia who hospitalized in the Third People′s Hospital of Ningxia were enrolled in the study.All the patients were divided into two groups according to the random digital table, with 50 cases in each group.The observation group was treated with losartan, and the control group was treated with irbesartan for 8 weeks.The total effective rate and adverse reactions were compared between the two groups.Also the changes of blood pressure, serum uric acid, fasting glucose(FBG), fasting insulin(FINS), high sensitivity C-reactive protein(hs-CRP), insulin sensitivity index(ISI) and insulin resistance index(HOMA-IR) were compared between the two groups after treatment. Results There was no statistically significant difference in the total effective rate between the two groups[92.0%(46/50) vs.90.0%(45/50)](P>0.05). Before treatment, there were no statistically significant differences in blood pressure, serum uric acid, FBG, FINS, hs-CRP, ISI and HOMA-IR between the two groups(all P>0.05). After treatment, the systolic blood pressure and diastolic blood pressure in the two groups were (133.09±10.11)mmHg vs.(131.54±11.01)mmHg and (82.76±6.23)mmHg vs.(83.75±6.88)mmHg, which were lower than those before treatment (observation group: t=19.742, 10.606, control group: t=18.925,-9.956, all P<0.05). But there were no statistically significant differences between the two groups(all P>0.05). After treatment, the serum uric acid in the observation group was lower than that in the control group[(387.21±25.56)μmol/L vs.(429.67±27.44)μmol/L](t=8.006, P<0.05). The hs-CRP, FINS, HOMA-IR, ISI in the observation group were (4.92±1.02)mg/L,(15.92±3.01)mU/L,(1.71±0.24),(1.047±0.095), which in the control group were (4.54±1.00)mg/L,(17.23�

关 键 词：高血压 高尿酸血症 女(雌)性 血压 尿酸 胰岛素敏感性 胰岛素抵抗 疗效比较研究 氯沙坦 厄贝沙坦 

分 类 号：R544.1[医药卫生—心血管疾病] R589.7[医药卫生—内科学]