小剂量螺内酯联合缬沙坦、氨氯地平对肥胖型高血压患者疗效及血清内脂素、瘦素的影响

摘要

目的:观察小剂量螺内酯联合缬沙坦、氨氯地平对肥胖型高血压患者的疗效及对血清内脂素、瘦素水平的影响.方法:选择2016年3月~2017年3月我院收治的肥胖型高血压患者106例为研究对象.患者被随机均分为常规治疗组(接受缬沙坦、氨氯地平以及常规治疗)和联合治疗组(在常规治疗组基础上加用小剂量螺内酯),两组均连续治疗8周.测量比较两组治疗前后收缩压(SBP)、舒张压(DBP)、人体质量指数(BMI)、腰围(WC)和血清醛固酮、内脂素和瘦素水平.结果:与治疗前比较,治疗8周后两组SBP、DBP、血清醛固酮、内脂素和瘦素水平均显著降低,P均=0.001;且与常规治疗组比较,联合治疗组治疗8周后SBP[(138.67 ± 9.34)mmHg比(127.52 ± 8.74)mmHg]、DBP [(93.27 ± 8.26)mmHg比(86.43 ± 7.98)mmHg]、血清醛固酮[(155.73 ± 16.43)ng/L比(121.49 ± 13.76)ng/L]、内脂素[(28.49 ± 4.13)ng/ml比(22.31 ± 3.64)ng/ml]和瘦素[(15.67 ± 4.82)ng/ml比(12.43 ± 3.74)ng/ml]水平降低更显著,P均=0.001.联合治疗组总有效率显著高于常规治疗组(96.23% 比83.02%),P=0.026.两组不良反应发生率(11.32% 比7.55%)无显著差异,P=0.740.结论:小剂量螺内酯联合缬沙坦、氨氯地平治疗肥胖型高血压患者疗效确切,可降低其血清内脂素和瘦素水平,值得推广.%Objective:To observe therapeutic effect of small dose spironolactone combined valsartan and amlodipine on obese patients with hypertension and its influence on serum levels of visfatin and leptin.Methods:A total of 106 obese patients with hypertension treated in our hospital from Mar 2016 to Mar 2017 were selected.They were ran-domly and equally divided into routine treatment group(received valsartan,amlodipine and routine treatment)and combined treatment group(received small dose spironolactone based on routine treatment group),both groups were continuously treated for eight weeks.Systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass in-dex(BMI),waist circumference(WC)and serum levels of aldosterone,visfatin and leptin before and after treat-ment were measured and compared between two groups.Results:Compared with before treatment,there were sig-nificant reductions in levels of SBP,DBP,serum aldosterone,visfatin and leptin in two groups after eight-week treatment,P=0.001 all;compared with routine treatment group after eight-week treatment,there were significant reductions in levels of SBP[(138.67 ± 9.34)mmHg vs.(127.52 ± 8.74)mmHg],DBP[(93.27 ± 8.26)mmHg vs. (86.43 ± 7.98)mmHg],serum aldosterone[(155.73 ± 16.43)ng/L vs.(121.49 ± 13.76)ng/L],visfatin[(28.49± 4.13)ng/ml vs.(22.31 ± 3.64)ng/ml]and leptin[(15.67 ± 4.82)ng/ml vs.(12.43 ± 3.74)ng/ml]in combined treatment group,P=0.001 all.Total effective rate of combined treatment group was significantly higher than that of routine treatment group(96.23% vs.83.02%),P=0.026. There was no significant difference in incidence rate of adverse reactions(11.32% vs.7.55%)between two groups,P=0.740. Conclusion:Small dose spironolactone combined valsartan and amlodipine possesses significant therapeutic effect on obese patients with hypertension,and it can reduce their serum levels of visfatin and leptin,which is worth extending.