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[目的]观察血管紧张素受体拮抗剂厄贝沙坦对急性脑梗死(ACI)患者血清瘦素水平的影响,并探讨其临床意义。[方法]选择89例临床研究对象,分为正常对照组(27例)、ACI对照组(32例)和ACI治疗组(30例)。ACI对照组和治疗组的患者均给予常规药物治疗2周;治疗组在常规治疗的基础上加用厄贝沙坦150mg,每日1次口服2周。所有研究对象均测定治疗前后的血压、血清血脂全项、高敏C-反应蛋白(hs-CRP)和瘦素浓度,并进行神经功能缺损程度(NDS)评分。[结果](1)与正常对照组比较,ACI患者血压(Bp)、血清甘油三酯(TG)、总胆固醇(Th)、低密度脂蛋白(LDL)和hs-CRP水平均明显升高,瘦素水平也显著升高(P﹤0.01)。(2)治疗2周后,ACI对照组和治疗组的hs-CRP和瘦素水平明显下降(P﹤0.05),但是ACI治疗组的改变更为显著(P﹤0.05);(3)治疗2周后,ACI对照组和治疗组的NDS均较治疗前下降,但是ACI治疗组变化更为明显(P﹤0.05)。[结论]厄贝沙坦能降低ACI患者血清瘦素水平,减轻神经功能缺损程度。
[Objective] To observe the effect of irbesartan, an angiotensin Ⅱ receptor antagonist, on serum leptin level in patients with acute cerebral infarction (ACI) and to explore its clinical significance. [Method] 89 clinical subjects were selected and divided into normal control group (27 cases), ACI control group (32 cases) and ACI treatment group (30 cases). ACI control group and treatment group patients were given conventional drug treatment for 2 weeks; the treatment group on the basis of conventional therapy plus irbesartan 150mg, 1 day orally for 2 weeks. All subjects were measured before and after treatment of blood pressure, serum total cholesterol, high-sensitivity C-reactive protein (hs-CRP) and leptin concentrations, and the degree of neurological deficit (NDS) score. [Results] (1) The levels of blood pressure (Bp), serum triglyceride (TG), total cholesterol (Th), low density lipoprotein (LDL) and hs-CRP in patients with ACI were significantly higher than those in the normal control group Leptin levels also significantly increased (P <0.01). (2) The levels of hs-CRP and leptin in ACI control group and treatment group decreased significantly (P <0.05) after 2 weeks of treatment, but the change in ACI group was more significant (P <0.05); (3) Afterwards, the NDS of ACI control group and treatment group decreased compared with that before treatment, but the change of ACI group was more obvious (P <0.05). [Conclusion] Irbesartan can reduce serum leptin levels and reduce the degree of neurological deficits in ACI patients.