论文部分内容阅读
目的研究替米沙坦对代谢综合征(MS)患者的治疗作用及对血管内皮细胞分泌功能的影响。方法我院就诊的新发MS患者198例,随机分为生活方式干预组(干预组,饮食控制+体育锻炼,n=86)和替米沙坦组(替米沙坦80mg/d+生活方式干预,n=112),治疗或干预4周。治疗及干预前后检测两组血压、空腹血糖、空腹胰岛素、血脂、一氧化氮、前列环素及内皮素1。结果与替米沙坦组治疗前比较,治疗后一氧化氮(39.5±10.2)比(55.5±12.1)μmol/L、前列环素(52.6±10.7)比(74.3±12.8)ng/L升高,内皮素1(54.8±9.9)比(42.9±8.4)ng/L降低,差异均有统计学意义(均P<0.01);与干预组干预前比较,干预后一氧化氮(40.3±9.5)比(44.2±8.9)μmol/L、前列环素(51.5±9.9)比(61.1±10.4)ng/L升高,内皮素1(55.6±10.7)比(50.9±9.2)ng/L降低,差异亦有统计学意义(均P<0.01)。与干预组干预后比较,替米沙坦组治疗后胰岛素抵抗指数[(0.5±0.2)比(0.7±0.2)]、内皮素1降低,一氧化氮、前列环素升高,差异均有统计学意义(均P<0.01)。结论替米沙坦能改善MS患者的胰岛素抵抗,纠正各项相关代谢指标,改善血管内皮细胞舒缩因子的分泌。
Objective To study the therapeutic effect of telmisartan on patients with metabolic syndrome (MS) and its effect on the secretion of vascular endothelial cells. Methods A total of 198 newly diagnosed MS patients admitted to our hospital were randomly divided into lifestyle intervention group (intervention group, diet control + physical exercise, n = 86) and telmisartan group (telmisartan 80mg / d + lifestyle intervention , n = 112) for treatment or intervention for 4 weeks. Blood pressure, fasting blood glucose, fasting insulin, blood lipids, nitric oxide, prostacyclin and endothelin 1 were measured before and after treatment and intervention. Results Compared with those before treatment, the levels of nitric oxide (39.5 ± 10.2) and (55.6 ± 12.1) μmol / L and 52.6 ± 10.7 and 74.3 ± 12.8 ng / L were higher in the telmisartan group (P <0.01). Compared with the pretreatment group, the levels of nitric oxide (40.3 ± 9.5) and ET1 (54.8 ± 9.9) and (42.9 ± 8.4) ng / (44.2 ± 8.9) μmol / L, 51.5 ± 9.9 (61.1 ± 10.4) ng / L, and ET-1 (55.6 ± 10.7) vs (50.9 ± 9.2) ng / L decreased Also statistically significant (all P <0.01). Compared with the intervention group, the insulin resistance index (0.5 ± 0.2) (0.7 ± 0.2), the decrease of ET-1 and the increase of nitric oxide and prostacyclin in the telmisartan group were statistically significant Significance (both P <0.01). Conclusion Telmisartan can improve insulin resistance in patients with MS, correct all the relevant metabolic parameters, and improve the secretion of vasoconstrictors of vascular endothelial cells.