摘要
目的:观察罗格列酮(rosiglitazone)对老年高血压并胰岛素抵抗患者心率变异性(HRV)的影响。方法:采用随机双盲、安慰剂对照研究方法,将62例老年原发性高血压并胰岛素抵抗患者随机分为罗格列酮组和安慰剂组,各口服罗格列酮4mg或安慰剂,每日1次,共16周,服药前后分别测定24h动态心电图、体质指数(BMI)、空腹胰岛素、空腹血糖、凝血因子Ⅰ和C反应蛋白。结果:罗格列酮组HRV时域及频域各项指标均有所提高(均P<0.01);胰岛素敏感性均显著提高(均P<0.01);空腹胰岛素、C反应蛋白和凝血因子Ⅰ明显降低(均P<0.01);24h平均收缩压和舒张压均降低(均P<0.05);空腹血糖和BMI差异无统计学意义(均P>0.05)。多元逐步回归分析结果表明空腹胰岛素是与HRV最为密切的因素(P<0.01)。结论:罗格列酮能有效改善老年原发性高血压并胰岛素抵抗症患者HRV,提高胰岛素敏感性,降低收缩压和舒张压,减少血液中心血管危险因子;空腹胰岛素是影响HRV的重要因素。
Objective:To examine the effect of rosiglitazone on heart rate variability in elderly hypertensive patients with insulin resistance.Method:This study was a randomized, double-blind, placebo-controlled clinical trial. All 62 elderly essential hypertensive patients with insulin resistance were randomized to rosiglitazone and control group. Subjects used rosiglitazone (4mg orally qid) or placebo and usual antihypertensive medicines (but not ACE inhibitors,ARB and β-receptor blocker) for 16 weeks. Before and after rosiglitazone treatment , 24 hour ambulatory electrocardiogram, fasting plasma insulin , fasting plasma glucose, body mass index (BMI), 24 hour ambulatory blood pressure monitoring,fibrinogen and C-reactive protein were also tested. Result: At the end of the study,the indexes of HRV, insulin sensitivity were improved significantly (P< 0.01, respectively). There were significant decreases in mean 24 h systolic and diastolic blood pressure(P< 0.05, respectively). Fibrinogen and C-reactive protein also declined(P< 0.01,respectively).There was no change in fasting plasma glucose and BMI(P> 0.05,respectively). Multiple factors regression analysis demonstrated that fasting plasma insulin (P< 0.01) was parameter that had close relationship with HRV. Conclusion:Rosiglitazone treatment of elderly hypertensive patients with insulin resistance improves HRV and insulin sensitivity, reduces systolic and diastolic blood pressure, and induces favorable changes in markers of cardiovascular risk. Insulin sensitizers provide cardiovascular benefits when used in the treatment of elderly essential hypertensive patients.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2005年第5期282-284,共3页
Journal of Clinical Cardiology
关键词
高血压
心率变异性
胰岛素抵抗
罗格列酮
Essential hypertension
Heart rate variability
Insulin resistance
Rosiglitazone
