卡维地洛对代谢综合征患者代谢指标影响探究.docVIP

卡维地洛对代谢综合征患者代谢指标影响探究 　［摘 要］ 目的：研究卡维地洛对代谢综合征患者血糖、血脂等代谢指标的影响。方法：入选60例符合代谢综合征诊断标准的轻度、中度高血压患者，并随机分为卡维地洛组和美托洛尔治疗组。在有效控制血压的同时，测量基础状态及接受治疗90天后的血糖、血胰岛素、及血脂水平等代谢指标。结果：用药前后，卡维地洛组胰岛素敏感性有所改善，美托洛尔组胰岛素敏感性无明显变化；用药后，美托洛尔组高密度脂蛋白（HDLC）水平下降，而卡维地洛组HDL水平变化不明显；卡维地洛组用药后载脂蛋白A（apoA）水平明显升高，而美托洛尔组无明显变化；其余代谢指标两组用药前后均未见明显变化。结论：卡维地洛对代谢综合征患者有效降压的同时，对其代谢指标无负面影响。　　［关键词］ 卡维地洛；美托洛尔；高血压；代谢综合征 　　The Effect of Carvedilol on Metabolic Parameters in Patients With Metabolic Syndrome 　　Abstact： Objective To explore the effect of cavedilol treatment on metabolic parameters in metabolic syndrome. Methods A total of 60 patients with stage12 hypertension who fulfilled at least 3 of the metabolic syndrome criteria proposed by NCEPATPⅢ were included in this study. Patients were randomly assigned to receive daily treatment with carvedilol and metoprolol. The biochemical parameters and insulin sensitivity based on the HOMAIR model were evaluated at baseline and at the end of treatment. Results A significant decrease in insulin resistance (HOMAIR) in carvedilol group compared to the metoprolol group ( percent change -6.2±0.2 vs. +0.5±1.3, Plt;0.05). A significant decrease in HDL cholesterol levels occurred in the metoprolol group compared to the carvedilol group (percent change: -6.7±10.2 vs.-0.5±11.3, Plt;0.05). A significant increase in apolipoprotein A1 level was observed in the carvedilol group compared to the metoprolol group (percent change: +5.7±9.7 vs. -0.7±12.6, Plt;0.05). There were no significant differences between the two groups respect to other parameters. Conclusion It is concluded antihypertensive pressure without adversely affecting metabolic parameters. 　　Key words: Cavedilol; Metoprolol; Metabolic syndrome; Hypertension. 　　代谢综合征是指包括高血压、高血糖、腹型肥胖和血脂代谢紊乱等一系列因素的临床综合征。对于代谢综合征患者，理想的抗高血压药物应当在有效降压的同时，能有利于改善或至少不恶化其血糖、血脂等代谢指标。以往研究证实［1，2］，α1受体拮抗剂、血管紧张素转换酶抑制剂（ACEI）和血管紧张素Ⅱ受体拮抗剂（ARB）对于代谢综合征患者的血糖、血脂代谢有所改善或无恶化作用。钙离子拮抗剂（CCB）对代谢因素无明确影响。而利尿剂和β受体阻滞剂可以增加其胰岛素抵抗和使血脂代谢进一步恶化。卡维地洛是第三代非选择性β受体阻滞剂，同时具有α和β受体阻滞作用。本研究旨在观察