替米沙坦联合二甲双胍和他汀类药物对伴MS高血压患者LVMI、IMT和CysC影响的研究
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摘要
目的研究替米沙坦联合二甲双胍、他汀类药物对高血压伴代谢综合征(MS)的左心室重量指数(LVMI)、颈动脉内膜中层厚度(IMT)及胱抑素C(CysC)的改善作用。方法选择原发性高血压伴MS患者102例,随机分为对照组(替米沙坦)50例和治疗组(替米沙坦+二甲双胍+阿托伐他汀)52例,分别治疗6个月,每周测血压2次,观察2组患者治疗前后血压血脂、LVMI、IMT、CysC及空腹血糖(FPG)、空腹胰岛素(FPI)、胰岛素敏感指数(ISI)的变化。结果治疗6个月后,除治疗组显示显著降脂外,2组在降低血压、改善LVMI、IMT、CysC水平及FPG、FPI、ISI方面,治疗后较治疗前比较差异均有统计学意义(P<0.05),但治疗组治疗后较对照组治疗后更显著(P<0.05)。结论替米沙坦联合二甲双胍、他汀类药物能显著改善高血压伴MS患者的LVMI、IMT、CysC水平,保护靶器官作用明显。
Objective To observe the effects of telmisartan combined with metformin and statins on left ventricular mass index(LVMI), carotid intima-media thickness(IMT) and cystatin C(CysC) in patients with hypertension complicated by metabolic syndrome(MS).Methods A total of 102 patients with primary hypertension complicated by MS were randomly divided into control group(telmisartan) and treatment group(telmisartan+metformin+atorvastatin),and these patients were treated for 6 months. The changes of blood pressure, blood lipid, LVMI, IMT, CysC, FPG, FPI and ISI before and after treatment were observed and compared between the two grousp.Results After 6-month treatment, except for the significant lipid-lowering effects in treatment group, there were significant differences in lowering blood pressure, improving the levels of LVMI, IMT, CysC levels, FPG, FPI, ISI in both groups before and after treatment(P<0.05). However, the improvement effects in treatment group after treatment were more significant than those in control group(P<0.05).Conclusion Telmisartan combined with metformin and statins can significantly improve the levels of LVMI, IMT and CysC in patients with hypertension complicated by MS, and can effectively protect target organs.
Objective To observe the effects of telmisartan combined with metformin and statins on left ventricular mass index(LVMI), carotid intima-media thickness(IMT) and cystatin C(CysC) in patients with hypertension complicated by metabolic syndrome(MS).Methods A total of 102 patients with primary hypertension complicated by MS were randomly divided into control group(telmisartan) and treatment group(telmisartan+metformin+atorvastatin),and these patients were treated for 6 months. The changes of blood pressure, blood lipid, LVMI, IMT, CysC, FPG, FPI and ISI before and after treatment were observed and compared between the two grousp.Results After 6-month treatment, except for the significant lipid-lowering effects in treatment group, there were significant differences in lowering blood pressure, improving the levels of LVMI, IMT, CysC levels, FPG, FPI, ISI in both groups before and after treatment(P<0.05). However, the improvement effects in treatment group after treatment were more significant than those in control group(P<0.05).Conclusion Telmisartan combined with metformin and statins can significantly improve the levels of LVMI, IMT and CysC in patients with hypertension complicated by MS, and can effectively protect target organs.
引文
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3 刘垚.替米沙坦对胰岛素抵抗及血压的影响.中国医药科学杂志,2013,318:101-102.
4 赵丽华.替米沙坦与二甲双胍联合治疗对高血压合并非酒精性脂肪肝病患者血压和糖脂代谢的影响.中华高血压杂志,2012,20:282-284.
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6 淡雪川,罗开良,刘丽,等.动脉硬化指数与高血压患者左室质量指数的关系.实用医学杂志,2008,24:1169-1170.
7 丁毅.2型糖尿病患者颈动脉内膜中层厚度与高血压的关系华.华夏医学,2011,24:186-187.
8 吕国伟.高血压患者血清胱抑素C与冠心病的关系.郑州大学,2013.
9 郑晓新,徐尚华,谢良地,等.替米沙坦对人血管内皮细胞炎性反应的影响及其相关机制.中华老年心脑血管杂志,2010,12:833-834.
10 向兰汀.阿托伐他汀联合二甲双胍对高血压合并代谢综合征患者血压的影响,湖北中医学院学报,2008,10:40-41.
11 赵琳琳,解汝娟.他汀类药物对慢性肾病的保护作用.中国血液净化,2012,11:332-333.
2 胡莲芬,石理,朱卫民,等.培多普利联合阿托伐他汀对高血脂症合并高血压病人保护靶器官功能的影响.中西医结合心脑血管病杂志,2008,6:772-774.
3 刘垚.替米沙坦对胰岛素抵抗及血压的影响.中国医药科学杂志,2013,318:101-102.
4 赵丽华.替米沙坦与二甲双胍联合治疗对高血压合并非酒精性脂肪肝病患者血压和糖脂代谢的影响.中华高血压杂志,2012,20:282-284.
5 杨晓红,李晓明.胰岛素抵抗与高血压的研究进展.中华现代临床医学杂志,2006,4:125-126.
6 淡雪川,罗开良,刘丽,等.动脉硬化指数与高血压患者左室质量指数的关系.实用医学杂志,2008,24:1169-1170.
7 丁毅.2型糖尿病患者颈动脉内膜中层厚度与高血压的关系华.华夏医学,2011,24:186-187.
8 吕国伟.高血压患者血清胱抑素C与冠心病的关系.郑州大学,2013.
9 郑晓新,徐尚华,谢良地,等.替米沙坦对人血管内皮细胞炎性反应的影响及其相关机制.中华老年心脑血管杂志,2010,12:833-834.
10 向兰汀.阿托伐他汀联合二甲双胍对高血压合并代谢综合征患者血压的影响,湖北中医学院学报,2008,10:40-41.
11 赵琳琳,解汝娟.他汀类药物对慢性肾病的保护作用.中国血液净化,2012,11:332-333.