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目的:研究替米沙坦对代谢综合征患者的治疗作用及对血管内皮细胞功能的影响。方法:代谢综合征患者198例连续序贯分为替米沙坦组112例和生活方式干预组86例。治疗前后分别检测血压、空腹血糖、空腹胰岛素、血脂、一氧化氮、前列环素、内皮素-1、超氧化物歧化酶、丙二醛,超声检测内皮依赖性血流介导的血管舒张功能。结果:替米沙坦组和生活方式干预组患者治疗后结果分别与治疗前比较,血压、空腹血糖、空腹胰岛素、血脂、一氧化氮、前列环素、内皮素-1、超氧化物歧化酶、丙二醛均有明显改善(P<0.01),内皮依赖性血管舒张功能明显改善(P<0.01);与生活方式干预组患者治疗后的结果比较,替米沙坦组治疗后的血压、空腹血糖、空腹胰岛素、血脂、一氧化氮、前列环素、内皮素-1、超氧化物歧化酶、丙二醛的改善及内皮依赖性血流介导的血管舒张功能改善也有统计学意义(P<0.01)。结论:替米沙坦改善代谢综合征患者内皮依赖性血流介导的血管舒张功能,与其改善患者的胰岛素抵抗、血管内皮细胞的分泌功能及氧化应激反应有关。
Objective: To study the therapeutic effect of telmisartan on patients with metabolic syndrome and its effect on the function of vascular endothelial cells. Methods: A total of 198 consecutive patients with metabolic syndrome were divided into telmisartan group (112 cases) and lifestyle intervention group (86 cases). Blood pressure, fasting blood glucose, fasting insulin, serum lipids, nitric oxide, prostacyclin, endothelin-1, superoxide dismutase and malondialdehyde were measured before and after treatment. Endothelium-dependent blood flow-mediated vasodilatation . Results: After treatment, the patients in the telmisartan group and lifestyle intervention group were compared with those before treatment. Blood pressure, fasting blood glucose, fasting insulin, blood lipids, nitric oxide, prostacyclin, endothelin-1, superoxide dismutase (P <0.01), and the endothelium-dependent vasodilation was significantly improved (P <0.01). Compared with the treatment group after lifestyle intervention, the blood pressure, The improvement of fasting blood glucose, fasting insulin, blood lipids, nitric oxide, prostacyclin, endothelin-1, superoxide dismutase and malondialdehyde and endothelium-dependent blood flow-mediated vasodilation were also statistically significant ( P <0.01). Conclusion: Telmisartan can improve endothelium-dependent blood flow-mediated vasodilatation in patients with metabolic syndrome, which is related to the improvement of insulin resistance, secretion of vascular endothelial cells and oxidative stress.