罗格列酮治疗高血压伴代谢综合征的疗效观察

Effects of rosiglitazone in treating hypertension associated with metabolic syndrome

目的研究罗格列酮对高血压伴代谢综合征患者的降压作用及对血浆胰岛素水平、血糖、甘油三脂(TG)、体重指数(BMI)、高敏C-反应蛋白(hsC-RP)的影响。方法32例糖负荷后血浆胰岛素增高(其中4例同时存在空腹胰岛素增高)伴高血压(≥140/90 mmHg)、肥胖(BMI>25)、脂代谢异常(TG>1.70 mmol/L)患者加用罗格列酮4 mg/d治疗12周,测定治疗前后血压、血糖、TG、BMI、hsC-RP、血浆胰岛素水平。结果治疗4周血压即有明显下降;治疗12周前后对比收缩压、舒张压、TG、BMI、口服糖耐量试验120 min(OGTT120 min)血糖、空腹胰岛素(FINS)、OGTT120min胰岛素水平均显著下降。结论①高血压伴代谢综合征患者胰岛素抵抗可能表现有糖后胰岛素水平异常增高;②罗格列酮能够有效改善高血压伴代谢综合征患者的胰岛素抵抗、降低血压、调节血脂、降低hsC-RP含量。

Objective To study the effects of rosiglitazone in the treatment of hypertension associated with metabolic syndrome. Methods 32 patients with refractory hypertension associated with metabolic disorder were given additional rosiglitazone 4 mg·d^-1 for 12 weeks, with the level of blood pressure and embolic indexes monitored to assess the effects. Results The patients hypertension was controlled at 4 week. Their metabolic indexes, including plasma insulin, plasma glucose, TG, body mass index （BMI） and serum hsC - reactive protein, were all significantly improved by 12 week （ P 〈 0. 01 or P 〈 0. 05 ）. Conclusion Now that an abnormal increase of plasma insulin after OGTT 120 min may represent insulin resistence （IR） syndrome first stage, rosiglitazone can improve the IR and reduce the levels of blood pressure, plasma glucose, plasma lipid, BMI and serum hsC - reactive protein in the patients with hypertension associated with metabolic syndrome.