氨氯地平与坎地沙坦酯联合治疗原发性高血压对患者血清LEP、SLR表达的影响

Effect of Amlodipine Combined with Candesartan Cilexetil on the Expression of Serum LEP and SLR in Patients with Essential Hypertension

目的 探讨氨氯地平联合坎地沙坦酯对原发性高血压患者血清LEP、SLR表达影响。方法 选取2015年12月至2017年9月来福建医科大学附属福清市医院就诊156例原发性高血压患者纳入本研究,随机分成对照组和观察组,每组78例。对照组患者使用坎地沙坦酯进行治疗,观察组在对照组的基础上联合氨氯地平进行治疗,治疗周期3个月。通过对比干预前后患者血压、血脂水平,以及肾功能指标和血清瘦素(LEP)、可溶性瘦素受体(SLR)水平来评估治疗效果。结果 3个月治疗结束后,观察组总有效率97.44%,高于对照组67.78%(P <0.05);治疗后两组患者总胆固醇(total cholesterol,TC),高密度脂蛋白(high density lipoprotein cholesterol,HDL-C),三酰甘油(triglyceride,TG)水平均有降低,HDL-C水平升高,且观察组与对照组相比有明显统计学差异(P <0.05);治疗后两组患者BUN水平较治疗前无明显变化(P> 0.05),肌酐(creatinine,Cr)、24 h尿白蛋白总量、尿微量白蛋白水平较治疗前降低(P <0.05),且观察组水平低于对照组(P <0.05),内生肌酐清除率(creatinine clearancerate,Ccr)水平较治疗前均上升,且观察组提高比对照组更为显著(P <0.05)。治疗后,观察组患者LEP水平低于对照组(P <0.05),SLR水平高于对照组(P <0.05)。结论 氨氯地平联合坎地沙坦酯可以显著改善患者的血脂水平、肾功能和瘦素抵抗效应,对原发性高血压患者具有较好的治疗效果。

Objective To investigate the effect of amlodipine combined with candesartan cilexetil on serum LEP and SLR expression in patients with essential hypertension.Methods A total of 156 patients with essential hypertension who came to Department of Cardiology Affiliated Fuqing City Hospital of Fujian Medical University from December 2015 to September 2017 were enrolled in the study and randomly divided into control group and observation group,with 78 cases in each group.The control group was treated with,candesartan cilexetil and the observation group was treated with amlodipine on the basis of the control group for a treatment period of 3 months.The therapeutic effects were evaluated by comparing blood pressure,blood lipid levels,renal function indicators,and serum leptin(LEP)and soluble leptin receptor(SLR)levels before and after intervention.Results After 3 months of treatment,the total effective rate of the observation group was 97.44%,which was higher than that of the control group(67.78%)(P<0.05).The levels of TC,HDL-C and TG were decreased in the latter two groups,and the level of HDL-C was increased.There was significant difference between the observation group and the control group(P<0.05).After treatment,the BUN levels of the two groups were not significantly different(P>0.05),Cr,24 h total urinary albumin and urinary microalbumin levels were higher than before treatment.The decrease was(P<0.05),and the level of the observation group was lower than that of the control group(P<0.05).The level of Ccr were higher than those before treatment,and the increase in the observation group was more significant(P<0.05).compared with the control group.After treatment,the LEP level in the observation group was significantly lower than that in the control group(P<0.05),and the SLR level was higher than the control group(P<0.05).Conclusions Amlodipine combined with candesartan cilexetil has a good therapeutic effect on patients with essential hypertension,and it can significantly improve the blood lipid level and renal function of patients at the same time,whatmore,it can also significantlt improve leptin resistance in patients.The therapy has good clinical application value.