替米沙坦联合硝苯地平控释片对肥胖性高血压患者的疗效观察

目的观察替米沙坦联合硝苯地平控释片对肥胖性高血压患者的疗效及对患者血脂和胰岛素抵抗的影响。方法选取2010年6月～2011年6月就诊的肥胖性高血压患者190例,随机分为观察组和对照组,两组各95例。对照组予以硝苯地平治疗,观察组在对照组基础上予以替米沙坦治疗。观察两组的疗效、血脂、体重指数（BMI）、空腹血糖（FPG）、空腹胰岛素（FIns）和稳态胰岛素评价指数（HOMA-IR）。结果观察组总有效率为92.63%,对照组总有效率为81.05%,观察组总有效率优于对照组,差异有统计学意义（χ2=4.606,P=0.032）。治疗后,观察组的TC、TG、BMI和HOMA-IR较治疗前和对照组明显降低,差异有统计学意义（P〈0.05或P〈0.01）。两组治疗前后的LDL-C、HDL-CFPG和FIns水平差异无统计学意义（P〉0.05）。结论替米沙坦联合硝苯地平控释片对肥胖性高血压疗效显著,有降低血脂水平、改善胰岛素抵抗的作用。

Efficacy of Telmisartan combined with Nifedipine in patients with obesity hypertension

Objective To observe the efficacy of Telmisartan combined with Nifedipine in patients with obesity hypertension and its effect on blood lipids and insulin resistance.Methods 190 obese patients with hypertension from June 2010 to June 2011 were randomly divided into observation group and control group,each group was 95 cases.Control group were given Nifedipine,Telmisartan were perfermed on the basis of the control group in observation group.The effect,blood lipids,body mass index(BMI),fasting plasma glucose(FPG),fasting insulin(FIns) and insulin homeostasis assessment index(HOMA-IR) were observed in each group.Results The total effective rate was 92.63% in the observation group,81.05% in the control group,the difference was statistically significant(χ2 = 4.606,P = 0.032).After treatment,The levels of TC,TG,BMI and HOMA-IR in the observation group were significantly lower than those before treatment and the control group,the differences were statistically significant(P < 0.05 or P < 0.01).The levels of LDL-C,HDL-CFPG and FIns before treatment were not statistically different compared with after treatment(P > 0.05).Conclusion The effect of Telmisartan combined with Nifedipine on blood pressure is very obvious,can decrease the blood lipid and improve the insulin resistance.