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目的探讨在高血压左室肥厚(LVH)患者应用厄贝沙坦治疗时对血清脂肪因子产生的影响及其机制,为临床高血压左室肥厚的治疗提供可靠依据。方法选取2015年8月至2017年2月在遵义医学院第五附属(珠海)医院住院诊疗的68例高血压合并LVH患者,随机分为两组,每组34例。厄贝沙坦组患者服用厄贝沙坦150 mg,1次/d;吲达帕胺组患者服用吲达帕胺2.5 mg,1次/d。对比两组患者在治疗前及治疗8周后收缩压(SBP)、舒张压(DBP)下降幅度,及甘油三酯(TG)、总胆固醇(TC)、空腹血糖(FBG)及Chemerin等指标的差异,比较舒张末期心功能指标如室间隔厚度(IVST)、左室厚度(LVPWT)及左心室质量指数(LVMI)。结果两组患者在治疗后SBP、DBP水平均较本组治疗前降低,但下降幅度比较差异无统计学意义(P>0.05),FBG、TG、TC治疗前后无明显差异(P>0.05);治疗后两组患者Chemerin均下降,其中厄贝沙坦组下降相对明显(P<0.05)。治疗后,厄贝沙坦组IVST、LVPWT及LVMI指标较治疗前有明显改善,差异有统计学意义(P<0.05);吲达帕胺组无明显改善,差异无统计学意义(P>0.05)。结论 ARB类药物不仅能够控制血压,在降低高血压合并LVH患者血清Chemerin水平及改善心室重构方面具有优势。
Objective To investigate the effect of irbesartan on serum adiponectin in hypertensive patients with left ventricular hypertrophy (LVH) and its mechanism, so as to provide a reliable basis for the treatment of hypertensive left ventricular hypertrophy. Methods A total of 68 hypertensive patients with LVH admitted to the Fifth Affiliated Hospital of Zunyi Medical College (Zhuhai Hospital) from August 2015 to February 2017 were randomly divided into two groups (34 in each group). Irbesartan patients taking irbesartan 150 mg, 1 / d; indapamide group patients taking indapamide 2.5 mg, 1 / d. The systolic blood pressure (SBP), DBP decline and triglyceride (TG), total cholesterol (TC), fasting blood glucose (FBG) and Chemerin were compared between the two groups before and 8 weeks after treatment Differences in end-diastolic cardiac function parameters such as IVST, LVPWT and LVMI were compared. Results The SBP and DBP levels in both groups decreased after treatment compared with before treatment, but there was no significant difference between the two groups (P> 0.05). There was no significant difference between FBG, TG and TC before and after treatment (P> 0.05). After treatment, Chemerin decreased in both groups, of which Irbesartan decreased significantly (P <0.05). After treatment, IVST, LVPWT and LVMI in irbesartan group were significantly improved compared with those before treatment, the difference was statistically significant (P <0.05); indapamide group had no significant improvement, the difference was not statistically significant (P> 0.05 ). Conclusion ARB drugs can not only control blood pressure, but also have an advantage in reducing serum Chemerin level and improving ventricular remodeling in patients with hypertension and LVH.