摘要
目的观察替米沙坦和氯沙坦对不稳定型心绞痛患者脂联素的影响,探讨具有过氧化物酶体增殖物活化受体(PPAR-γ)部分激动作用的血管紧张素Ⅱ受体阻滞剂(ARB),在改善不稳定型心绞痛患者预后的价值。方法不稳定型心绞痛患者119例,随机分为替米沙坦组与氯沙坦组。替米沙坦组给予口服替米沙坦80 mg/d;氯沙坦组给予口服氯沙坦50 mg/d,药物治疗12周。观察给药前和治疗2周、4周后脂联素水平;并随访心血管事件的发生,包括心绞痛、心肌梗死、心功能不全、心律失常、脑卒中、心因性死亡等。结果替米沙坦组和氯沙坦组患者服药前空腹血清脂联素水平比较差异无统计学意义,(3.04±1.41)mg/L vs(2.85±1.36)mg/L(P>0.05);服药4周后,两组患者血清脂联素水平与服药前比较均升高,替米沙坦组血清脂联素水平较氯沙坦组明显增高,(10.92±2.08)mg/L vs(7.85±1.51)mg/L(P<0.01)。随访过程中,氯沙坦组心脑血管并发症发生率高于替米沙坦组,但差异无统计学意义(P>0.05)。结论替米沙坦提高不稳定型心绞痛患者脂联素水平明显优于氯沙坦,并有改善不稳定型心绞痛患者预后的趋势。
Objective To observe the different effects between telmisartan and losartan on serum adiponectin in patients with unstable angina,and the evaluation in improving atherosclerosis of patients with unstable angina. Methods 119 patients with unstable angina were randomly divided into two groups, telmisartan group and losartan group. Patients in telmisartan group took telmisartan 80 mg/d before breakfast, patients in losartan group losartan 50 mg/d, the treatment period was 12 weeks. All the patients were detected adiponectin level before,two weeks and four weeks after the treatment respectively. The cardiovascular events(angina pectoris, myocardia infarction, congestive heart failure and death) were carefully observed for 12 weeks. Results There was no significant difference between two groups in adiponectin level before treatment, (3. 04 ± 1.41 ) mg/L vs (2.85 ± 1.36) mg/L ( P 〉0. 05). After treatment of telmisartan and losartan,adiponectin level increased significantly than that before treatment in both groups. Compared with losartan group, serum adiponectin after treatment in telmisartan group was significantly higher, (10.92 ±2.08) mg/L vs (7.85±1.51) mg/L( P〈0. 01). Cardiovascular events after treatment were lower in telmisartan group than in losartan group,but there was no significant difference between two groups( P〉0. 05). Conclusion Telmisartan is better than losartan in increasing adiponectin level. Telmisartan probably improves the prognosis in patients with unstable angina.
出处
《临床荟萃》
CAS
2009年第5期393-395,共3页
Clinical Focus