替米沙坦改善代谢综合征患者血管内皮功能
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Telmisartan Improves Vascular Endothelial Function in Patients with Metabolic Syndrome
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    摘要:

    目的观察替米沙坦对代谢综合征患者血管内皮功能的影响。方法76例代谢综合征患者随机分为常规组和替米沙坦组,每组38例,同时选择健康体检者38例作为对照组。替米沙坦组在常规用药的基础上加服替米沙坦80 mg/d,治疗3个月。检测三组患者治疗前后血糖、血脂代谢指标、血浆一氧化氮含量及炎症因子肿瘤坏死因子α、白细胞介素6和C反应蛋白水平,观察血压及血管内皮舒张功能变化。结果治疗后常规组和替米沙坦组的血压、空腹血糖均明显下降(P<0.01),但两组间的血压、空腹血糖相比差异无统计学意义(P>0.05)。治疗后替米沙坦组的肱动脉血流介导的舒张内径(FMD)(P<0.05)、一氧化氮含量明显升高(P<0.01),肿瘤坏死因子α、白细胞介素6和C反应蛋白水平降低(P<0.05),且与常规组相比差异有统计学意义(P<0.05);而常规组FMD、一氧化氮含量及炎症因子水平与治疗前比无明显变化(P>0.05)。结论替米沙坦可降低代谢综合征患者血浆炎症因子水平,抑制炎症反应,升高一氧化氮含量,改善血管内皮功能。

    Abstract:

    Aim To investigate the effect of telmisartan on vascular endothelial function in patients with metabolic syndrome.Methods 76 cases of patients with metabolic syndrome were recruited,and randomized to receive conventional treatment(n=38) or telmisartan(80 mg/d) on the basis of conventional treatment(n=38) for 3 months.Thirty-eight healthy persons were chosen as control group.The plasma level of glucose and lipid metabolism,nitric oxide(NO) and cytokines of each group before and after treament were determined.The blood pressure and endothelial relaxation function were also measured.Results The blood glucose and blood pressure in telmisartan group and conventional group were all decreased after treatment(P<0.01),without intergroup differences(P>0.05).In telmisartan group,the flow-mediated diameter(FMD) and NO were obviously increased(P<0.05 and P<0.01),and the plasma tumor necrosis factor α(TNF-α),interleukin-6(IL-6) and C-reactive protein(CRP) were decreased(P<0.05),with intergroup differences(P<0.05).No obvious changes of FMD,NO and inflammatory factors were found in conventional group.Conclusion Telmisartan can improve vascular endothelial function in patients with metabolic syndrome by raising concentration of NO and inhibiting inflammatory reaction with decreased level of cytokines.

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龚丽娅, 蓝光明, 黄秋霞.替米沙坦改善代谢综合征患者血管内皮功能[J].中国动脉硬化杂志,2011,19(5):431~434.

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  • 收稿日期:2010-10-31
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