厄贝沙坦对高血压病并左室肥厚血清抵抗素水平的影响

目的 对比血管紧张素受体拮抗剂(ARB)和钙离子拮抗剂(CCB)对高血压病并左室肥厚(LVH)患者血清抵抗素水平的影响.方法 选择临床LVH患者76例,随机分为ARB治疗组(38例)和CCB治疗组(38例),分别给予ARB厄贝沙坦片(150 mg/d)和CCB非洛地平缓释片(5mg/d)口服6个月.所有入选患者均在治疗前后测定血压(BP)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室质量指数(LVMI)和抵抗素水平.结果 治疗前两组患者的Bp、IVST、LVPWT、LVMI和抵抗素水平差异均无统计学意义(P＞0.05)；治疗6个月后,ARB治疗组与CCB治疗组的Bp均明显下降(P＜0.05),下降幅度差异无统计学意义,ARB治疗组IVST、LVPWT、LVMI较治疗前明显改善(P＜0.05),而CCB治疗组无明显改变(P＞0.05)；治疗6个月后,两组患者的血清抵抗素水平均明显降低,但是ARB治疗组更加显著(P＜0.05).结论 与CCB比较,ARB除了降低血压外还可以进一步降低抵抗素水平,改善高血压左室肥厚患者的左室重构.

Effect of irbesartan on serum concentration of resistin in hypertension patients with left ventricular hypertrophy.

Objective To observe the effects of angiotensin receptor blocker （ARB） and calcium channel blocker （CCB） on serum concentration of resistin in hypertension patients with left ventricular hypertrophy （LVH）. Methods Seventy-six patients with LVH were randomly divided into ARB group （n=38） and CCB group （n=38）. Patients in ARB group were treated with orally ARB irbesartan tablet （150 mg/d） and those in the CCB group were teated with CCB felodipine tablet （5 mg/d）, both for a course of six months. Blood pressure （Bp）, interventricular septum thickness （IVST）, left ventricular posterior wall thickness （LVPWT）, left ventricular mass index （LVMI） and resistin levels were evaluated before and a~ter treatment in both groups. Results There were no differences in parameters of Bp, IVST, LVPWT, LVMI, resistin level before treatment in both groups （/：＇〉0.05）. Bp obviously decreased after treatment compared to those before treatment in both groups （P〈0.05）, and there was no difference between the ARB group and the CCB group. The parameters of IVST, LVPWT, LVMI were apparently improved after treatment in the ARB group （P〈O.05）, and there were no changes in the CCB group （/：＇〉0.05）. The concentrations of resistin obviously decreased after treatment compared to those before treatment, in both groups, however, change of resistin after treatment in the ARB group was significant compared to thai in the CCB group （P〈0.05）. Conclusion Compared to CCB, ARB can not only lower Bp, but also can reduce serum resistin level, and improve ventricular remodeling in hypertension patients with LVH.