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目的:探讨替米沙坦对肥胖高血压患者血压、糖脂代谢指标和血清脂联素、高敏C反应蛋白的影响及其机制。方法:选取23例超体质量或肥胖的原发性高血压患者,给予替米沙坦40 mg,1次/d,2周后增至80 mg,1次/d,每2周随访1次,记录心率、血压、体质量,必要时加用长效钙拮抗剂,治疗16周。观察用药前、后患者腰围、腰臀比、体质量指数、血压、空腹血糖、胰岛素、血脂和血清脂联素及高敏C反应蛋白的变化。采用稳态模式法计算胰岛素抵抗指数。结果:与治疗前比较,治疗后患者收缩压、舒张压及胰岛素抵抗指数均明显下降(P<0.01),血清脂联素升高(P<0.01),高敏C反应蛋白水平降低(P<0.05)。结论:替米沙坦可改善肥胖伴高血压患者的胰岛素敏感性,升高血清脂联素水平、降低高敏C反应蛋白水平。
Objective: To investigate the effects of telmisartan on blood pressure, glucose and lipid metabolism, serum adiponectin and high-sensitivity C-reactive protein in patients with obesity and its mechanism. Methods: Twenty-three patients with essential hypertension or obesity were enrolled. Patients were given telmisartan 40 mg once daily for 2 weeks and then increased to 80 mg once daily for 2 weeks. Heart rate, blood pressure, body weight, if necessary, add long-acting calcium antagonist for 16 weeks. The changes of waist circumference, waist-hip ratio, body mass index, blood pressure, fasting blood glucose, insulin, serum lipids, serum adiponectin and high-sensitivity C-reactive protein were observed before and after treatment. Insulin resistance index was calculated using the steady-state model. Results: Compared with those before treatment, systolic blood pressure, diastolic blood pressure and insulin resistance index decreased significantly (P <0.01), serum adiponectin increased (P <0.01) and high sensitive C-reactive protein decreased ). Conclusion: Telmisartan can improve insulin sensitivity, increase serum adiponectin level and decrease high sensitivity C-reactive protein in obese patients with hypertension.