厄贝沙坦氢氯噻嗪对肥胖性高血压病患者血脂及胰岛素抵抗的影响

目的探讨厄贝沙坦氢氯噻嗪对肥胖性高血压病患者血脂及胰岛素抵抗的影响。方法肥胖型高血压病患者80例,随机分为2组各40例,观察组予以厄贝沙坦氢氯噻嗪治疗,对照组予以左旋氨氯地平治疗。观察2组治疗前后血压、体质量指数(BMI)、血脂、空腹血糖(FBG)、空腹胰岛素(FPI)和稳态模式法的胰岛素抵抗指数(HOMA-IR)。结果 2组治疗后收缩压和舒张压均较治疗前明显降低(P均<0.01),观察组较对照组下降更为显著(P<0.05或<0.01)。治疗后观察组的总胆固醇、三酰甘油和HOMA-IR较治疗前明显降低(P均<0.05),与对照组比较有显著性差异(P均<0.05)。而2组治疗前后BMI、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、FBG和FPI无显著性差异(P均>0.05)。结论厄贝沙坦氢氯噻嗪可有效降低肥胖性高血压患者的血压,可能与改善胰岛素敏感性、降低患者的血脂水平有关。

Effect of irbesartan and hydrochlorothiazide on insulin resistance and lipid in hypertensive patients with obesity

Objective It is to approach the influence of irbesartan and hydrochlorothiazide on insulin resistance and lipid in hypertensive patients with obesity.Methods Eighty obese hypertensive patients were randomly divided into two groups,each group were 40 cases.Observation group was treated with irbesartan and hydrochlorothiazide and the control group was received amlodipine.The blood pressure,body mass index(BMI),blood lipids,fasting plasma glucose(FBG),fasting insulin(FPI) and homeostasis model insulin resistance index method(HOMA-IR) were observed before and after treatment.Results After treatment,the systolic and diastolic blood pressure were significantly lower than those before treatment,but the levels of observation group decreased more significantly(P<0.05 or 0.01).After treatment,the levels of total cholesterol,triglycerides and HOMA-IR were significantly lower than those before treatment or in control group(all P<0.05).The levels of BMI,LDL-C,HDL-C,FBG and FPI in both groups were not significantly different compared with before and after treatment(allP>0.05).Conclusion Irbesartan and hydrochlorothiazide can effectively reduce blood pressure in obese hypertensive patients,it’s mechanism may be related to improve insulin sensitivity,lower blood lipid levels.