替米沙坦对代谢综合征患者血管内皮功能的影响

目的观察替米沙坦对代谢综合征患者血管内皮功能的影响。方法代谢综合征患者76例随机分为常规组和实验组,每组38例,同时选择健康体检者38例作为对照组。实验组在常规用药的基础上加服替米沙坦80mg/d,治疗3个月。检测三组患者治疗前后血糖、血脂代谢指标、血浆一氧化氮（NO）、丙二醛（MDA）含量及超氧化物歧化酶（SOD）活性,观察血压及血管内皮舒张功能变化。结果治疗后常规组和实验组的血压、空腹血糖均明显下降（P〈0.05）,但两组间的血压、空腹血糖相比差异无统计学意义（P〉0.05）;实验组的肱动脉血流介导的舒张内径（FMD）（P〈0.05）、NO含量明显升高（P〈0.01）,MDA含量下降、SOD活性升高（P〈0.05）。治疗后常规组FMD、NO及MDA含量、SOD活性均无明显变化（P〉0.05）,与实验组相比差异有统计学意义（P〈0.05）。结论替米沙坦可减轻代谢综合征患者胰岛素抵抗及氧化应激水平,增加一氧化氮含量,改善血管内皮功能。

Effect of telmisartan on vascular endothelial function in patients with metabolic syndrome

Objective To investigate the effect of telmisartan on vascular endothelial function in patients with metabolic syndrome.Methods 76 patients with metabolic syndrome were recruited,and randomized to receive conventional treatment(n=38) or telmisartan(80mg/d) on the basis of conventional treatment(n=38) for 3 months.38 healthy persons were chosen as control group.The plasma level of glucose and lipid metabolism,nitric oxide(NO) and the indexes(MDA,SOD) of antioxidation in each group before and after treatment were determined.The blood pressure and endothelial relaxation function were also measured.Results The blood glucose and blood pressure in telmisartan group and conventional group were all decreased after treatment(P<0.05),without intergroup differences.In telmisartan group,the flow-mediated diameter(FMD) and NO were obviously increased(P<0.05;P<0.01),and changes of indexes of antioxidation also had statistic significance(P<0.05).But no obvious changes in conventional group were found,with intergroup differences(P<0.05).Conclusion Telmisartan can improve vascular endothelial function in patients with metabolic syndrome by raising concentration of NO which reduces insulin resistance and oxidative stress level.