卡维地洛联合替米沙坦对高血压患者糖脂代谢的影响

Effect of carvedilol combined with telmisartan on glucose and lipid metabolism in patients with hypertension

目的探讨卡维地洛联合替米沙坦对高血压患者的治疗效果,并评价其对患者糖脂代谢的影响。方法 120例顽固性高血压患者为研究对象,均采用卡维地洛联合替米沙坦进行治疗;治疗开始前1 d与治疗28 d后分别检测患者血压及糖脂代谢情况,并进行分析比较。结果治疗后患者收缩压(139.13±20.65)mm Hg(1 mm Hg=0.133 k Pa)与舒张压(108.61±13.31)mm Hg均低于治疗前的(178.84±32.01)、(140.07±18.96)mm Hg,差异均具有统计学意义(P<0.05)。治疗后,患者餐后血糖(PBG)、空腹胰岛素(FIns)、餐后2 h胰岛素(2 h Ins)水平及稳态模型胰岛素抵抗指数(HOMA-IR)均低于治疗前,差异均具有统计学意义(P<0.05);治疗前后患者空腹血糖(FPG)水平比较差异无统计学意义(P>0.05)。治疗前后患者总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)水平比较差异均无统计学意义(P>0.05)。结论卡维地洛与替米沙坦联合用药能改善顽固性高血压患者收缩压与舒张压,效果良好,该降压效果可能是通过改善患者胰岛素抵抗发挥作用的。

Objective To investigate the treatment effect of carvedilol combined with telmisartan forpatients with hypertension,and evaluate its effect of on glucose and lipid metabolism of patients.Methods Atotal of120refractory hypertension patients as study subjects were all treated with carvedilol and telmisartan.Blood pressure and glucose and lipid metabolism condition in patients were measured1d before treatmentand28d after treatment for comparative analysis.Results After treatment,patients had lower systolic bloodpressure as(139.13±20.65)mm Hg(1mm Hg=0.133kPa)and diastolic blood pressure as(108.61±13.31)mmHg than(178.84±32.01)and(140.07±18.96)mm Hg before treatment,and their difference was statisticallysignificant(P<0.05).After treatment,patients had lower postprandial blood glucose(PBG),fasting insulin(FIns),2h postprandial insulin(2h Ins)level and homeostasis model assessment of insulin resistance(HOMA-IR)thanbefore treatment,and their difference was statistically significant(P<0.05).Patients had no statistically significantdifference in fasting plasma glucose(FPG)before and after treatment(P>0.05).Patients had no statisticallysignificant difference in total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL)and low densitylipoprotein(LDL)(P>0.05).Conclusion Combined therapy of carvedilol and telmisartan provides excellent effectin improving systolic and diastolic blood pressure in patients with refractory hypertension,and the antihypertensiveeffect may be achieved by improving insulin resistance in patients.