替米沙坦对高血压病患者左室肥厚和胰岛素抵抗的影响

Influence of Telmisartan on Left Ventricular Hypertrophy and Insulin Resistance in Patients with Hypertension

目的探讨原发性高血压患者经替米沙坦治疗后其血胰岛素抵抗及左室肥厚的变化。方法对56例高血压病患者和56例健康对照者测定空腹及餐后2h血糖、胰岛素、C肽值,计算胰岛素敏感指数,进行超声心动图检查。高血压病患者接受替米沙坦降压治疗21周后,复查上述指标并与用药前进行对比研究。结果替米沙坦对高血压病患者能够显著降低血压,提高胰岛素敏感指数(P<0.01),室间隔厚度、左室后壁厚度、左室心肌重量及左室重量指数较治疗前显著改善(P<0.01)。结论胰岛素抵抗可能是高血压病患者合并左室肥厚的诱发因素之一。替米沙坦在降压的同时,具有改善其胰岛素抵抗和左室肥厚的作用。

Objective To investigate the changes in insulin resistance and left ventricular hypertrophy after the treatment of telmisartan in patients with essential hypertension. Method The concentrations of fasting blood glucose, serum insulin and C peptide （CP） were measured in 56 hypertensive patients and 56 control healthy subjects. The insulin sensitivity index（ISI） of each group was calculated. Echocardiography was examined. After telmisartan was used to treat hypertension for 21 weeks,the above laboratory tests were re-examined and contrasted. Results After 21 weeks treatment of telmisartan, blood pressure reduced significantly （P 〈 0.01 ）, ISI increased（P 〈 0.01 ）. Interventricular septum thickness,left ventricular posterior wall thickness,left ventricular myocardial mass and index of left ventricular mass were improved significantly （ P 〈 0.01 ）. Conclusions Insulin resistance might be one of induced factors of left vertricular hypertrophy in patients with hypertension. Besides decreasing blood pressure, telmisartan has the function of improving insulin resistance and left ventricular hypertrophy.