氯沙坦钾治疗老年肥胖型高血压病的疗效及其对胰岛素抵抗的影响

【目的】观察氯沙坦钾治疗老年肥胖型高血压病的疗效及其对血脂，胰岛素抵抗的影响。【方法】选择在2009年1月至2010年12月在本院治疗的肥胖型高血压病患者110例，将其随机分为观察组和对照，每组各55例，观察组予以氯沙坦钾治疗，对照组予以硝苯地平治疗，观察两组治疗前后血压，空腹血糖（FBG），血空腹胰岛素（FPI），血脂和稳态模式法的IR指数（HOMA_IR）。【结果】两组治疗后，收缩压和舒张压均较治疗前明显降低（P〈0．01），但两组治疗后相比较差异无统计学意义（P〉O．05）。观察组治疗后总胆固醇，甘油三酯和HOMA_IR水平较治疗前和观察组明显降低，差异有统计学意义（P〈O．01），而体重指数（BMI），高密度脂蛋白胆固醇和低密度脂蛋白胆固醇，FPG和FPI水平，两组治疗前后无明显变化（P〉0．05）。【结论】氯沙坦钾治疗高血压病的疗效显著，对老年高血压病患者的血脂和胰岛素抵抗有一定的缓解作用。

Therapeutic effect in elderly patients with obesity on hypertension with losartan and its effect oninsulin resistance

Objective]To observe therapeutic effect in elderly patients with obesity on hypertension with losartan and its effect on blood lipids and insulin resistance. Methods]ll0 patients with hypertension and obe sity from January 2009 to 2010 in December in our hospital were randomly divided into observation group and control group, each group had 55 cases, the observation group was treated with losartan and the control group was treated with nifedipine. The blood pressure, fasting blood glucose （FBG）, fasting plasma proinsulin （FPI）, blood lipids, and homeostatic model assessment IR index （HOMAIR） were observed before and after treatment. Results]After treatment, the systolic and diastolic blood pressure were significantly lower than those before treatment in two groups（ P %0.01）, but after treatment, there no statistically significant differ ence between observation group and control group （ P 2〉0.05）. After treatment, the levels of total cholester ol, triglyceride and HOMAIR in observation group were significantly lower than those before treatment and in control group, the difference was statistically significant （ P %0.01）, and the levels of BMI, high density lip oprotein cholesterol and lowdensity lipoprotein cholesterol, FPG, and FPI were no significant change before and after treatment（ P ）0. 05）. Conclusion]The effect of losartan on hypertension were obvious and the blood lipids and insulin resistance in elderly patients with hypertension have a role in mitigation.