目的 評價阿利沙坦酯對輕度高血壓合并糖調(diào)節(jié)受損患者血清炎癥因子、頸動脈內(nèi)膜中層厚度以及心血管事件發(fā)生率的影響。方法 選擇2019年3月—2020年2月在南方醫(yī)科大學(xué)附屬佛山醫(yī)院就診的門診或住院86例輕度高血壓合并糖調(diào)節(jié)受損患者，隨機分為對照組（41例）和治療組（45例）。對照組主要給予飲食控制以及生活方式指導(dǎo)；治療組除飲食控制以及生活方式指導(dǎo)外，同時清晨空腹阿利沙坦酯片，240 mg/次，1次/d，持續(xù)服藥6個月。比較治療前后兩組患者心血管事件、臨床療效、炎癥因子及頸動脈內(nèi)膜中層厚度。結(jié)果 治療后，治療組患者收縮壓（SBP）、舒張壓（DBP）較治療前顯著降低（P<0.05）；且治療后治療組血壓低于對照組（P<0.05）。治療后，治療組患者總膽固醇（TC）水平較治療前顯著降低（P<0.05）；治療后治療組TC水平低于對照組（P<0.05）。治療后，治療組患者空腹血糖（FPG）和餐后2 h血糖（2 h PG）較治療前顯著降低（P<0.05）；且治療后治療組血糖水平顯著低于對照組（P<0.05）。治療后，治療組患者血清白細胞介素6（IL-6）、超敏C反應(yīng)蛋白（hs-CRP）及頸動脈內(nèi)膜中層厚度較治療前均明顯降低（P<0.05）；治療后治療組炎癥因子及頸動脈內(nèi)膜中層厚度低于對照組（P<0.05）。結(jié)論 阿利沙坦酯除有效控制輕度高血壓外，還可以增強胰島素敏感性，且有一定的抗炎和抗動脈粥樣硬化作用，對于輕度高血壓合并糖調(diào)節(jié)受損患者早期使用阿利沙坦酯，有助于減少心血管事件的發(fā)生。

Objective To study the effects of alisartan axetil on inflammatory factors and carotid intima-media thickness in patients with mild hypertension complicated with impaired glucose regulation.Methods A total of 86 patients with mild hypertension complicated with impaired glucose regulation were selected from the outpatients or inpatients of Foshan Hospital Affiliated to Southern Medical University from March 2019 to February 2020, and they were randomly divided into control group (41 cases) and treatment group (45 cases). Patients in the control group were mainly given diet control and lifestyle guidance, while patients in the treatment group fasting administered with Allisartan Isoproxil Tablets in the morning in addition to diet control and lifestyle guidance, 240 mg/time, once daily, and they were treated for 6 months. After treatment, cardiovascular events, clinical efficacy, inflammatory factors and intima-media thickness of carotid artery in two groups before and after treatment were compared.Results After treatment, the systolic blood pressure (SBP) and diastolic blood pressure (DBP) in treatment group were significantly decreased compared with After treatment, the TC level in treatment group was lower than that in control group (P<0.05). After treatment, fasting blood glucose (FPG)before treatment (P<0.05). After treatment, blood pressure in treatment group was lower than that in control group (P<0.05). After treatment, the total cholesterol (TC) level in treatment group was significantly decreased compared with before treatment (P<0.05). and 2 h postprandial blood glucose (2 h PG) in treatment group were significantly decreased compared with before treatment (P<0.05). After treatment, the blood glucose level of treatment group was significantly lower than that of control group (P<0.05). After treatment, serum interleukin 6 (IL-6), hypersensitive C-reactive protein (hs-CRP) and carotid intima media thickness in treatment group were significantly decreased compared with before treatment (P<0.05). After treatment, inflammatory factors and carotid intima media thickness in treatment group were lower than those in control group (P<0.05).Conclusion Allisartan isoproxil can not only effectively control mild hypertension, but also enhance insulin sensitivity, and has certain anti-inflammatory and anti-atherosclerotic effects. Early use of allisartan isoproxil in patients with mild hypertension with impaired glucose regulation helps to reduce the incidence of cardiovascular events.

R971

廣東省醫(yī)學(xué)科研基金項目（A2017550）