氯沙坦钾及厄贝沙坦对高血压伴高尿酸血症患者血压和胰岛素敏感性的影响

Effects of Losartan Potassium and Irbesartan on blood pressure and insulin sensitivity in hypertensive patients with hyperuricemia

目的比较氯沙坦钾及厄贝沙坦对高血压伴高尿酸血症患者血压及胰岛素敏感性的影响。方法选择2010年6月至2010年12月的70例门诊高血压伴高尿酸患者,随机分成两组分别给予氯沙坦钾50～100mg/d(A组)及厄贝沙坦150～300mg/d(B组),治疗8周,检测治疗前后血压、空腹血糖(FBG)、空腹胰岛素(FINS)、血尿酸(UA)、高敏C反应蛋白(Hs-CRP)并计算治疗前后胰岛素敏感指数(ISI)及记录有无不良反应的发生,治疗前后作比较,并设对照组35例,进行组间比较。结果治疗8周后,高血压患者各项指标达到目的水平(P<0.01),空腹胰岛素和胰岛素敏感指数较治疗前显著改善(P<0.05)。结论高血压合并高尿酸血症患者存在明显胰岛素抵抗,氯沙坦钾及厄贝沙坦均可有效控制血压并改善高血压并高尿酸患者的胰岛素抵抗,两者相比较,以氯沙坦钾改善更为显著。

Objective To compevre the effects of Losartan Potassium and Irbesartan on blood pressure and insulin sensitivity in hypertensive patients with hyperuricemia.Methods From June 2010 to December,2010,70 cases of hypertensive patients with hyperuricemia were enrolledand and randomly divided into two groups. A group were administrated orally with Losartan Potassium at a dose of 50 to 100 mg per day for eight weeks and B group were treated with Irbesartan. Before and after treatment,blood pressure （BP）,fasting blood glucose （FBG）,fasting insulin （FINS）, uric acid（VA）, Hs-CRP were determined and calculated insulin sensitive index （ISI）. The adverse effects were recorded during follow up period. Results Eight weeks after treatment, hypertensive patients reached to the target level（P0.01）. The FINS level of patients decreased and ISI of patients significantly improved at the end of treatment when compared with that before treatment （P0.05）. Conclusion Losartan Potassium and Irbesartan can effectively control BP and improve ISI in hypertensive pa- tients with hyperuricemia.Losartan potassium improve ISI significantly when compared with Irbesartan.