氯沙坦联用葛根素对原发性高血压左心室肥厚的逆转及胰岛素抵抗的影响

Effects of Losartan with Puerarin on the Reversion of Left Ventricular Hypertrophy and Insulin Resistance in Patients with Essential Hypertension

目的观察氯沙坦单用或联用葛根素对原发性高血压并左室肥厚(LVH)的逆转作用及其对胰岛素抵抗的影响。方法60例原发性高血压并左室肥厚病人随机分成两组:对照组(A组)30例口服氯沙坦,每日50mg;治疗组(B组)30例给予氯沙坦,每日50mg,加葛根素注射液500mg。两组均持续治疗4周。观察左室形态结构和左室功能变化及其对胰岛素抵抗的影响。结果两组治疗后,血压水平降低,室间隔厚度(I VST)、左室后壁厚度(LVPWT)、左室舒张末期内径(LVDd)、左室重量(LVMI)均显著下降(P<0.05或P<0.01),特别是B组在逆转LVH方面效果优佳(P<0.05)。与A组比较,B组治疗后2h血糖和空腹胰岛素明显降低,而胰岛素敏感性指数明显升高。结论氯沙坦联用葛根素治疗原发性高血压,既可有效降压,又可逆转LVH以及改善胰岛素抵抗。

Objective To study the effects of losartan and losartan with puerarin on reversion of the left ventricular hypertrophy（LVH） and insulin resistance in patients （pts） with essential hypertension. Methods Sixty elderly pts with hypertension and left ventricular hypertrophy were divided into 2 groups randomly： control group （Group A） treated with losartan （50mg/d）and treatment group （Group B） treated with losartan （50mg） and puerarin （500 mg） for 4 weeks. The data of structure and function of the left ventricle, insulin resistance（IR） were collected pre- and post - therapy. Results The blood pressure （SBP and DBP）, the left ventricular mass index （LVMI）, and diastolic interventricular septum thickness （IVST）, left ventricular posterior wall thickness（LVPWT）, and left ventricular diameter （LVDd） in two group was reduced significantly after treatment （P〈 0.01 or P〈0.05）. The LVMI in treatment group was reduced more significantly than that in control group （P 〈 0.05）. Compared to control group, 2 hours glucose and fasting insulin decreased but insulin sensitive index increased significantly in treatment group. Conclusion Losartan with Puerarin increased the effect of anti - hypertension and reversion of left ventricular hypertrophy, and improved IR signif- icantly than Losartan alone.