CAJ | 학술논문

目的：观察替米沙坦和缬沙坦对肥胖高血压患者胰岛素抵抗影响。方法肥胖标准为体重指数(BMI)≥25 kg·(m2)-1的原发性高血压患者68例,随机分为替米沙坦组33例和缬沙坦组35例,服药前及服药16周后监测血压、空腹血糖、空腹胰岛素(Fins)及胰岛素抵抗指数(HOMA-IR)。结果两组服药前后比较,收缩压/舒张压差异均有统计学意义(P<0.01)。替米沙坦组治疗前和治疗16周后 Fins 分别为(12.9±2.9),(10.9±2.2)mU·L-1,HOMA-IR 分别为(3.1±0.7),(2.7±0.6)(均 P<0.01),缬沙坦组治疗前和治疗16周后 Fins 分别为(12.9±3.0),(12.7±2.7) mU·L-1, HOMA-IR 分别为(3.0±0.7),(3.0±0.7)(均 P>0.05)。两组治疗后 Fins 和 HOMA-IR 比较差异有统计学意义(P<0.01)。结论替米沙坦和缬沙坦有等同的降压效应,但替米沙坦在改善肥胖高血压患者胰岛素抵抗方面优于缬沙坦。
목적：관찰체미사탄화힐사탄대비반고혈압환자이도소저항영향。방법비반표준위체중지수(BMI)≥25 kg·(m2)-1적원발성고혈압환자68례,수궤분위체미사탄조33례화힐사탄조35례,복약전급복약16주후감측혈압、공복혈당、공복이도소(Fins)급이도소저항지수(HOMA-IR)。결과량조복약전후비교,수축압/서장압차이균유통계학의의(P<0.01)。체미사탄조치료전화치료16주후 Fins 분별위(12.9±2.9),(10.9±2.2)mU·L-1,HOMA-IR 분별위(3.1±0.7),(2.7±0.6)(균 P<0.01),힐사탄조치료전화치료16주후 Fins 분별위(12.9±3.0),(12.7±2.7) mU·L-1, HOMA-IR 분별위(3.0±0.7),(3.0±0.7)(균 P>0.05)。량조치료후 Fins 화 HOMA-IR 비교차이유통계학의의(P<0.01)。결론체미사탄화힐사탄유등동적강압효응,단체미사탄재개선비반고혈압환자이도소저항방면우우힐사탄。
Objective To observe the effects of telmisartan and valsartan on insulin resistance in obese hypertensive patients. Methods Sixty-eight patients with essential hypertension and body mass index ( BMI) ≥25 kg · ( m2 ) -1 were randomly divided into the telmisartan group (33 cases) and valsartan group (35 cases). Blood pressure, fasting serum glucose, fasting insulin (Fins) and insulin resistance (HOMA-IR) were measured before and after 16 weeks treatment. Results Compared with basal levels, SBP and DBP were significantly decreased in both group ( P<0. 01). Fins and HOMA-IR were significantly decreased in telmisartan group [(12. 9±2. 9) mU·L-1 vs. (10. 9±2. 2) mU·L-1 (P<0. 01); (3. 1±0. 7) vs. (2. 7±0. 6) (P<0. 01), respectively], while no such changes were found in valsartan group [(12. 9 ±3. 0) mU·L-1 vs. (12. 7±2. 7) mU·L-1 ( P > 0. 05);( 3. 0 ± 0. 7) vs. (3. 0 ± 0. 7) ( P > 0. 05), respectively]. Conclusion In obese hypertensive patients, telmisartan and valsartan exert similar antihypertensive effect, but telmisartan may have a benefit in insulin resistance in comparison to valsartan.