替米沙坦對原發性高血壓患者血清脂聯素和頸動脈IMT的影響

馮建民

【摘要】 目的：探討替米沙坦對原發性高血壓患者血清脂聯素和頸動脈內膜中層厚度（IMT）的影響。方法：選取2017年1月-2018年1月在筆者醫院就診238例原發性高血壓患者作為研究對象。采用計算機隨機數字表法將研究對象分為兩組，各119例，分別命名為觀察組和對照組。對照組采用鹽酸貝那普利片治療，觀察組采用替米沙坦膠囊治療。比較兩組臨床療效及治療前后的脂聯素水平和頸動脈IMT。結果：觀察組患者治療有效率明顯高于對照組，差異有統計學意義（P<0.05）。治療后，觀察組患者脂聯素水平較治療前明顯升高，頸動脈IMT較治療前明顯減小，差異有統計學意義（P<0.05）。結論：替米沙坦治療原發性高血壓的降壓效果理想，同時可通過調節原發性高血壓患者血脂聯素水平，發揮抗動脈粥樣硬化的作用。

【關鍵詞】 替米沙坦; 原發性高血壓; 脂聯素; 內膜中層厚度

doi：10.14033/j.cnki.cfmr.2019.27.008 文獻標識碼 B 文章編號 1674-6805（2019）27-00-02

Effects of Telmisartan on Serum Adiponectin and Carotid IMT in Patients with Essential Hypertension/FENG Jianmin.//Chinese and Foreign Medical Research，2019，17（27）：-19

【Abstract】 Objective：To investigate the effects of Telmisartan on serum adiponectin and carotid intima-media thickness（IMT） in patients with essential hypertension.Method：A total of 238 patients with essential hypertension were enrolled in the authors hospital from January 2017 to January 2018.The subjects were divided into two groups by computer random number table method，119 cases each，which were named as observation group and control group.The control group was treated with Benazepril Hydrochloride Tablets，and the observation group was treated with Telmisartan Capsules.The clinical efficacy of the two groups as well as adiponectin levels and carotid IMT before and after treatment were compared.Result：The effective rate of treatment in the observation group was significantly higher than that in the control group，and the difference was statistically significant（P<0.05）.After treatment，the level of adiponectin in the observation group was significantly higher than that before treatment，the carotid IMT was significantly lower than that before treatment，and the difference was statistically significant（P<0.05）.Conclusion：Telmisartan is effective in the treatment of essential hypertension，and it can exert anti-atherosclerosis by regulating the level of blood adiponectin in patients with essential hypertension.

【Key words】 Telmisartan; Essential hypertension; Adiponectin; Intima-media thickness

First-authors address：Nanping First Hospital Affiliated to Fujian Medical University，Nanping 353000，China

2017年華南地區5省市流行病學調查顯示，高血壓患病率已高達22.27% [1]。其中，90%～95%的高血壓屬于原發性高血壓[2]。血壓異常升高、異常波動易引起冠狀動脈粥樣硬化性心臟病（冠心病）、腦卒中、心肌梗死等心腦血管并發癥，嚴重影響患者的生活質量[3]。原發性高血壓的治療以降低血壓水平，減少靶器官損害為目的[4]。Michishita等[5]在動物實驗中發現，替米沙坦可以上調原發性高血壓模型大鼠血清脂聯素水平，同時觀察到心肌細胞的脂聯素受體Ⅰ表達增加。本研究旨在探討替米沙坦對原發性高血壓患者血清脂聯素和頸動脈內膜中層厚度（IMT）的影響，為治療方案的制定提供臨床數據支撐。