文章摘要
罗伟华,唐毓启,蒙庆旭,韦秋霞,覃康.厄贝沙坦治疗老年单纯收缩期高血压的效果及其对胰岛素抵抗的影响[J].中国临床保健杂志,2020,23(6):827-830.
厄贝沙坦治疗老年单纯收缩期高血压的效果及其对胰岛素抵抗的影响
Clinical effects of irbesartan on isolated systolic hypertension and insulin resistance in the elderly
投稿时间:2020-04-24  
DOI:10.3969/J.issn.1672-6790.2020.06.026
中文关键词: 高血压  胰岛素抗药性  厄贝沙坦  硝苯地平  老年人
英文关键词: Hypertension  Insulin resistance  Irbesartan  Nifedipine  Aged 〖FL
基金项目:广西省来宾市科学研究与技术开发项目(来科攻163013)
作者单位E-mail
罗伟华 广西合山市人民医院,临床药学室,合山 546508 13878203990@163.com 
唐毓启 广西合山市人民医院,心血管内科,合山 546508 13878203990@163.com 
蒙庆旭 广西合山市人民医院,消化呼吸内科,合山 546508 13878203990@163.com 
韦秋霞 广西合山市人民医院,临床药学室,合山 546508 13878203990@163.com 
覃康 广西合山市人民医院,临床药学室,合山 546508 13878203990@163.com 
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中文摘要:
      目的 探讨厄贝沙坦降压的同时对患者胰岛素抵抗的影响,以及对其安全性进行临床评价。方法 老年单纯收缩期高血压(ISH)160例,分2组,每组80例。一组给予口服厄贝沙坦片,每日1次,每次150 mg;另一组给予硝苯地平片,每次10~20 mg,2次/d或3次/d,总疗程均为8周。治疗期间跟踪观察,并记录患者的血压、心率、空腹血糖、空腹胰岛素及药物相关不良反应。结果 患者口服厄贝沙坦1周后收缩压开始明显降低于治疗前(P<0.05);治疗结束时,患者空腹胰岛素水平和胰岛素敏感指数明显低于治疗前(P<0.05);治疗前后心率、血糖均无明显差异,差异无统计学意义(P>0.05)。随访期间出现咳嗽1例。头晕1例,不良反应总发生率为2.5%。与硝苯地平组比较,厄贝沙坦的降压效果与硝苯地平的相似,但对胰岛素水平和胰岛素敏感性改善更明显,同时不良反应也比硝苯地平的轻。结论 厄贝沙坦治疗老年患者单纯收缩期高血压疗效确切,可明显降低老年单纯收缩期高血压,改善胰岛素敏感性,对心率和血糖无明显影响,药物不良反应轻微。
英文摘要:
      Objective To investigate the effect of irbesartan on hypertension in elderly patients with insulin resistance and assess its clinical safety.Methods A total of 160 elderly patients with isolated systolic hypertension (ISH) were divided into two groups (80 persons per group).One group were orally administrated with irbesartan (150 mg) once daily,and the other group were given nifedipine (10-20 mg) 2 or 3 times daily for 8 weeks.During the period of the treatment,the general symptoms and signs were observed,and the key items including blood pressure,heart rates,fasting blood glucose and insulin,as well as drug-related adverse symptoms were recorded.Results Irbesartan could significantly decreased the systolic blood pressure after the treatment for 1 week (P<0.05),and reduced the fasting insulin level and insulin sensitivity index at the end of treatment (P<0.05).There was little difference in heart rate and blood sugar level before and after treatment (P>0.05).During the follow-up,there were one patient with cough and one with giddiness,the total incidence rate of adverse reactions was 2.5%.Compared with the nifedipine group,irbesartan had the similar anti-hypertension effect,but better insulin sensitivity and less adverse reactions.Conclusion Irbesartan is effective in treating elderly isolated systolic hypertension with improved insulin sensitivity and less adverse reactions.
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