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目的探讨氯沙坦钾对原发性高血压患者高敏C反应蛋白(hs-CRP)及稳态模型评估的胰岛素抵抗指数(HOMA-IR)的影响。方法选择51例轻中度原发性高血压患者,经2周安慰剂洗脱后随机分为2组,治疗组给予氯沙坦钾,每日50mg,对照组给予硝苯地平缓释片10mg,每日2次。疗程为8周。在2周洗脱期末及8周末空腹抽静脉血,测定hs–CRP、血糖、胰岛素水平,用HOMA-IR公式计算胰岛素抵抗指数。比较治疗前后hs–CRP、空腹胰岛素、HOMA–IR变化。结果两组患者治疗8周后,收缩压、舒张压均有显著下降,差异有统计学意义(P<0.001);氯沙坦组治疗后血清hs-CRP、空腹胰岛素水平、HOMA-IR明显降低,与治疗前比较差异有统计学意义(P<0.05)。对照组治疗后hs-CRP、空腹胰岛素水平、HOMA-IR与治疗前比较差异无统计学意义(P>0.05)。氯沙坦组治疗前后hs-CRP、空腹胰岛素水平、HOMA-IR变化值与对照组比较差异有统计学意义(P<0.05,P<0.01,P<0.05)。两组治疗前后血糖水平差异无统计学意义。结论氯沙坦钾有效控制血压,降低hs-CRP水平,有改善胰岛素抵抗作用。
Objective To investigate the effect of losartan potassium on high-sensitivity C-reactive protein (hs-CRP) and homeostasis model assessment (HOMA-IR) in patients with essential hypertension. Methods Fifty-one patients with mild-to-moderate essential hypertension were randomly divided into two groups after two weeks of placebo. The patients in the treatment group were given losartan potassium 50 mg daily. The control group was given nifedipine 10 mg , 2 times a day. The course of treatment is 8 weeks. Hs-CRP, blood glucose and insulin levels were measured at the end of the two-week elution period and the fasting venous blood at the end of the 8th week. The HOMA-IR formula was used to calculate the index of insulin resistance. The changes of hs-CRP, fasting insulin and HOMA-IR before and after treatment were compared. Results After treatment for 8 weeks, the systolic and diastolic blood pressures decreased significantly in both groups (P <0.001); the levels of serum hs-CRP, fasting insulin and HOMA-IR in losartan group were significantly decreased , Which was significantly different from that before treatment (P <0.05). There was no significant difference in hs-CRP, fasting insulin and HOMA-IR between the two groups after treatment (P> 0.05). The changes of hs-CRP, fasting insulin and HOMA-IR in losartan group before and after treatment were significantly different from those in control group (P <0.05, P <0.01, P <0.05). There was no significant difference in blood glucose level between the two groups before and after treatment. Conclusion Losartan potassium can effectively control blood pressure, reduce hs-CRP level and improve insulin resistance.