坎地沙坦对高血压合并2型糖尿病患者血浆尾加压素Ⅱ和脂联素的影响

Influences of candesartan on plasma urotensin Ⅱ and adiponectin in patients with hypertension complicating type 2 diabetes

目的：比较坎地沙坦和非洛地平对高血压合并2型糖尿病患者的降压作用及血浆尾加压素Ⅱ（UⅡ）、脂联素（ADI）水平的影响。方法纳入2011年5月~2012年6月湖北医药学院太和医院高血压合并2型糖尿病患者84例，随机分为坎地沙坦组（n=43）和非洛地平组（n=41）。前者予坎地沙坦（4mg， qd），后者予非洛地平片（5mg，qd），疗程均为16周。比较两种药物的降压效果，并分别采用酶联免疫吸附法（ELISA）及放射免疫法测定治疗前后患者静脉血中UⅡ、ADI和血管紧张素Ⅱ（AngⅡ）的水平，观察这两种不同的降压药物对上述血管活性物质的影响。结果两组患者血压均较治疗前下降，但两组间无统计学差异。治疗前两组血浆UⅡ、ADI、AngⅡ水平无统计学差异（P＞0.05），治疗16周后，与非洛地平组比较，试验组患者血浆中UⅡ水平明显下降[（6.17±1.45）pmol/L vs.（8.92±1.21）pmol/L， P＜0.01]，ADI水平明显升高[（6.13±1.45）mg/L vs.（4.12±1.46）mg/L，P＜0.01]，AngⅡ水平两组间无统计学差异[（149.72±22.89）mg/L vs.（143.27±23.88）mg/L，P＞0.05]。结论坎地沙坦与非洛地平治疗合并2型糖尿病高血压疗效接近，同时可改善胰岛素抵抗，增加血管弹性。

Objective To compare the antihypertensive effects of candesartan and felodipine and their influences on the levels of plasma urotensinⅡ（UⅡ） and adiponectin （ADI） in the patients with hypertension complicating type 2 diabetes. Methods The patients （n=84） were chosen and randomly divided into candesartan group （4 mg, qd） and felodipine group （5 mg, qd） and treated for 16 weeks. The antihypertensive efficacies of these two drugs were compared. The levels of plasma UⅡ, ADI and angiotensinⅡ（AngⅡ） were detected by applying enzyme-linked immunosorbent assay （ELISA） and radioimmunoassay before and after treatment. The influences of these two drugs on the above-mentioned vasoactive substances were observed. Results The level of blood pressure decreased in tow groups after treatment but there was no statistical difference between two groups. The levels of U II, ADI and AngⅡhad no statistical difference between two groups before treatment （P〉0.05）, and after treatment for 16 weeks, in candesartan group, compared with felodipine group, U II level decreased significantly [（6.17±1.45） pmol/L vs. （8.92±1.21） pmol/L, P〈0.01], ADI level increased significantly [（6.13±1.45） mg/L vs. （4.12±1.46） mg/L, P〈0.01], and AngⅡlevel had no statistical difference between two groups [（149.72±22.89） mg/L vs. （143.27 ±23.88） mg/L, P〉0.05]. Conclusion Candesartan is superior to felodipine in reducing the levels of UⅡand ADI in the patients with hypertension complicating type 2 diabetes.