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目的研究不同剂量奥美沙坦对原发性高血压(Essential hypertension,EH)患者血压及胰岛素抵抗(insulin resistance,IR)的影响。方法 EH患者65例随机分成A组(奥美沙坦20mg)33例,B组(奥美沙坦40mg)32例,治疗12周。观察两组治疗前后的动态血压(ABPM)、空腹血糖(FPG)和胰岛素(FINS)、胰岛素敏感指数(ISI)和胰岛素抵抗指数(HOMA-IR)水平的变化。结果①治疗后两组EH患者血压水平均较治疗前明显降低,B组较A组更为明显,差异有统计学意义(P<0.05)。②治疗后两组ISI均明显高于治疗前,B组升高更为明显,差异有统计学意义(P<0.05);治疗后两组HOMA-IR均明显低于治疗前,B组降低更为明显,差异有统计学意义(P<0.05)。结论奥美沙坦可有效降压及改善胰岛素抵抗,且存在剂量相关性。
Objective To investigate the effects of different doses of olmesartan on blood pressure and insulin resistance (IR) in patients with essential hypertension (EH). Methods Sixty-five patients with EH were randomly divided into group A (olmesartan 20 mg), group B (olmesartan 40 mg), and group B (n = 32) for 12 weeks. The levels of ABPM, FPG and FINS, insulin sensitivity index (ISI) and insulin resistance index (HOMA-IR) in both groups before and after treatment were observed. Results ① After treatment, the blood pressure of EH patients in both groups was significantly lower than that before treatment, and the B group was more obvious than that of A group (P <0.05). ② After treatment, the ISI in both groups was significantly higher than that before treatment, and the increase in group B was more obvious with significant difference (P <0.05); HOMA-IR in both groups after treatment was significantly lower than before treatment, and in group B decreased more For obvious, the difference was statistically significant (P <0.05). Conclusion Olmesartan can be effective antihypertensive and improve insulin resistance, and there is a dose-related.