替米沙坦对原发性高血压患者血清脂联素和颈动脉IMT的影响

冯建民

【摘要】 目的：探讨替米沙坦对原发性高血压患者血清脂联素和颈动脉内膜中层厚度（IMT）的影响。方法：选取2017年1月-2018年1月在笔者医院就诊238例原发性高血压患者作为研究对象。采用计算机随机数字表法将研究对象分为两组，各119例，分别命名为观察组和对照组。对照组采用盐酸贝那普利片治疗，观察组采用替米沙坦胶囊治疗。比较两组临床疗效及治疗前后的脂联素水平和颈动脉IMT。结果：观察组患者治疗有效率明显高于对照组，差异有统计学意义（P<0.05）。治疗后，观察组患者脂联素水平较治疗前明显升高，颈动脉IMT较治疗前明显减小，差异有统计学意义（P<0.05）。结论：替米沙坦治疗原发性高血压的降压效果理想，同时可通过调节原发性高血压患者血脂联素水平，发挥抗动脉粥样硬化的作用。

【关键词】 替米沙坦; 原发性高血压; 脂联素; 内膜中层厚度

doi：10.14033/j.cnki.cfmr.2019.27.008 文献标识码 B 文章编号 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年華南地区5省市流行病学调查显示，高血压患病率已高达22.27% [1]。其中，90%～95%的高血压属于原发性高血压[2]。血压异常升高、异常波动易引起冠状动脉粥样硬化性心脏病（冠心病）、脑卒中、心肌梗死等心脑血管并发症，严重影响患者的生活质量[3]。原发性高血压的治疗以降低血压水平，减少靶器官损害为目的[4]。Michishita等[5]在动物实验中发现，替米沙坦可以上调原发性高血压模型大鼠血清脂联素水平，同时观察到心肌细胞的脂联素受体Ⅰ表达增加。本研究旨在探讨替米沙坦对原发性高血压患者血清脂联素和颈动脉内膜中层厚度（IMT）的影响，为治疗方案的制定提供临床数据支撑。