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目的对比血管紧张素受体拮抗剂(ARB)和钙离子拮抗剂(CCB)对高血压病并左室肥厚(LVH)患者血清抵抗素水平的影响。方法选择临床LVH患者76例,随机分为ARB治疗组(38例)和CCB治疗组(38例),分别给予ARB厄贝沙坦片(150 mg/d)和CCB非洛地平缓释片(5 mg/d)口服6个月。所有入选患者均在治疗前后测定血压(Bp)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室质量指数(LVMI)和抵抗素水平。结果治疗前两组患者的Bp、IVST、LVPWT、LVMI和抵抗素水平差异均无统计学意义(P>0.05);治疗6个月后,ARB治疗组与CCB治疗组的Bp均明显下降(P<0.05),下降幅度差异无统计学意义,ARB治疗组IVST、LVPWT、LVMI较治疗前明显改善(P<0.05),而CCB治疗组无明显改变(P>0.05);治疗6个月后,两组患者的血清抵抗素水平均明显降低,但是ARB治疗组更加显著(P<0.05)。结论与CCB比较,ARB除了降低血压外还可以进一步降低抵抗素水平,改善高血压左室肥厚患者的左室重构。
Objective To compare the effects of angiotensin receptor blocker (ARB) and calcium channel blocker (CCB) on serum resistin in patients with hypertension and left ventricular hypertrophy (LVH). Methods Sixty-six patients with clinical LVH were randomly divided into ARB treatment group (38 cases) and CCB treatment group (38 cases), and were given ARB irbesartan tablets (150 mg / d) and CCB felodipine extended release tablets 5 mg / d) orally for 6 months. Blood pressure (Bp), interventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPWT), left ventricular mass index (LVMI) and resistin levels were measured in all patients before and after treatment. Results There was no significant difference in the levels of Bp, IVST, LVPWT, LVMI and resistin between the two groups before treatment (P> 0.05). After 6 months of treatment, the Bp of ARB treatment group and CCB treatment group decreased significantly (P <0.05). There was no significant difference between the two groups (P> 0.05), while the levels of IVST, LVPWT and LVMI in ARB group were significantly improved (P <0.05) Serum resistin levels were significantly lower in both groups, but the ARB treatment group was more significant (P <0.05). Conclusion Compared with CCB, ARB can not only lower blood pressure, but also reduce the level of resistin and improve left ventricular remodeling in hypertensive patients with left ventricular hypertrophy.