超声评价罗格列酮对肥胖高血压病病人左室肥厚的影响

The Effect of Rosiglitazone on Left Ventricular Hypertrophy in Obese Patients with Essential Hypertension

目的探讨罗格列酮对肥胖高血压病病人左室肥厚的影响及可能的机制。方法57例肥胖高血压伴左室肥厚病人,随机分为对照组(28例)及治疗组(29例),对照组给予罗布麻、氢氯噻嗪(双氢克尿噻)降压治疗,治疗组在此基础上合用罗格列酮片每天4mg,疗程均12月,观察治疗前后超声左室质量指数(LVMI),并测定血浆自由脂肪酸(FFA)、内皮素-1(ET-1)、一氧化氮(NO)。结果与治疗前比较,治疗组LVMI、FFA、ET-1降低,NO增加(P<0.01),LVMI与ΔFFA、ΔET-1呈正相关(r=0.43,0.45,P<0.05),与ΔNO呈负相关(r=-0.38,P<0.05),对照组无明显变化(P>0.05)。结论罗格列酮逆转肥胖高血压病病人左室肥厚,可能与改善内皮功能及脂肪酸代谢有关。

Objective To investigate the effect of rosiglitazone on left ventricular hypertrophy in obese patients （pts） with essential hypertension. Methods Fifty seven obese pts with essential hypertension and left ventricular hypertrophy were randomly divided into control group （n = 28） treated with Luobuma and hydrochlorothiazide, and rosiglitazone group（n = 29） treated with Luobuma, hydrochlorothiazide and rosiglitazone 4 mg/d for 12 months. The data of left ventricular mass index （LVMI）, serum nitric oxide（NO）, endothelin - 1 （ET - 1 ） and free fatty acids（FFA） were collected pre - and post - therapy. Results LVMI,FFA and ET-1 decreased, NO increased in rosiglitazone group（P〈 0.01 ） ,ALVMI was positively correlated with AET- 1 and AFFA（ r = 0.45, 0.43, P 〈 0.05）, and negatively with ANO（ r = - 0.38, P 〈 0.05）. No significant change was found in control group （P 〉0.05）, Conclusion Rosiglitazone is effective for regression of left ventricular hypertrophy in obese pts with essential hypertension, It is possibly involved improvement of endothelial function and fatty acids metabolism,