替米沙坦对代谢综合征合并高血压患者内脏脂肪沉积的影响

目的观察替米沙坦对代谢综合征（MS）合并原发性高血压（EH）患者内脏脂肪沉积的影响。方法选择合并MS的EH患者60例，按随机数字表法分为两组，每组30例，试验组给予替米沙坦40mg，1次／d治疗；对照组给予缬沙坦80mg，1次／d治疗，直至24周动态血压监测平均血压〈140／90mmHg（1mmHg：0．133kPa），采用多层螺旋CT影像学检查受试者皮下脂肪面积（SFA）和内脏脂肪面积（VFA），同时检测体质量指数（BMI）、血压、血糖、胰岛素抵抗指数（HOMA—IR）、糖化血红蛋白（HbA1c）水平。结果两组治疗前血压、BMI、血糖、HbA1c、血脂等一般临床资料比较差异无统计学意义（P〉0．05）；试验组治疗后VFA较治疗前显著降低（127．8±16．6）cm2比（150．5±15．4）cm2]，差异有统计学意义（P〈0．05），对照组治疗前后VFA比较差异无统计学意义（P〉0．05）；试验组和对照组治疗前后SFA均无明显改变，差异无统计学意义（P〉0．05）；试验组治疗后HOMA—IR较治疗前显著降低（1．9±0．3比4．2±0．9），血清脂联素水平较治疗前显著增加（5．77±0．71）mg／L比（3．16±0．72）mg／L]，差异有统计学意义（P〈0．05）。结论与缬沙坦比较，替米沙坦可显著减少MS合并EH患者内脏脂肪沉积，改善胰岛素抵抗。

The effects of telmisartan treatment on the abdominal fat deposit in metabolic syndromecombined with essential hypertension

Objective To observe the effects of telmisartan treatment on the abdominal fat deposit in metabolic syndrome （MS） combined with essential hypertension （EH）. Methods Sixty patients of MS combined with EH were divided into two groups according to random number table method, with 30 cases in each group. The patients in experimental group were given telmisartan orally 40 mg once a day, and in control group were given valsartan 80 mg once a day,until average ambulatory blood pressure monitoring blood pressure was 〈 140/90 mmHg （1 mmHg =0.133 kPa） in 24 weeks. The visceral fat area （VFA） and subdermal fat area （SFA） was measured by multislice CT, at the same time the body mass index （BMI）, blood pressure, blood glucose, homeostasis model assessment of insulin resistance （HOMA-IR） and glyeosylated hemoglobin （HbAlc） of the subjects was measured. Results The blood pressure, BMI, blood glucose, HbAic, and blood lipids between two groups before treatment had no statistical significance （P 〉 0.05 ）. VFA in experimental group after treatment was lower than that before treatment （ 127.8 ±16.6） cm： vs. （150.5 ± 15.4） cm2] （P 〈 0.05 ）. But there was no statistical significance of VAF in control group before and after treatment （P 〉0.05）. The SFA in experimental group and control group had no statistical significance before and after the treatment （P 〉 0.05）. The HOMA-IR in experimental group after treatmentwas reduced compared with that before treatment （1.9 ± 0.3 vs. 4.2 ± 0.9 ）,and adiponectin was increased （5.77 ±0.71） mg/L vs. （3.16 ±0.72） mg/L ] （P 〈0.05）. Conclusion Compared with valsartan, telmisartan can significantly reduce the visceral fat deposition in MS combined with EH patients and improve insulin resistance.