依那普利与二甲双胍联合治疗肥胖性高血压的临床观察

目的：肥胖与高血压的发生、发展密切相关，肥胖人群更容易发生高血压，而目前我国肥胖和高血压的发生率大幅上升，至今仍无针对肥胖性高血压的指南。研究表明，二甲双胍有改善代谢以外的降压作用，ACEI有降压以外的改善代谢作用。本研究的目的为观察二甲双胍联合依那普利对肥胖性高血压患者血压、体重指数（BMI）、腰围及血脂的影响效果。方法：76例诊断为肥胖性高血压的患者随机分成观察组和对照组，观察组38例患者给予二甲双胍＋依那普利治疗；对照组38例患者给予依那普利治疗，观察期为24周，并于治疗前及治疗24周后测定血脂（TG、TC,HDL—C、LDL-C）、BMI、腰围（WC）变化。每2周门诊随访并记录血压。结果：①经24周治疗后，两组患者血压（MDBP、MSBP）均明显降低，P〈0．05，且二甲双胍＋依那普利观察组的降压作用明显优于依那普利对照组（P〈O．05）；②观察组的体重指数（BMI）、腰围（WX）、血脂水平（TC、TG、HDL-C、LDL-C）较治疗前显著下降（P〈O．05），而对照组较治疗前无明显变化（P〉0．05）。结论：二甲双胍＋依那普利对肥胖性高血压患者不仅具有良好的降压效果作用而且能降低BMI，WC及血脂水平。是肥胖性高血压较理想的治疗方案。

Enalapril Combination with Metformin Therapy of Obesity-Associated Hypertension

Objective： Occurrence of obesity and hypertension, the development is closely related to obesity are more likely to high blood pressure, and the incidence of obesity and hypertension increased in our country significantly. There still no guidelines for obesity hypertension, studies have shown that metformin has antihypertensive effect other than to improve the metabolic, ACEI, there is relief to improve the metabolism outside. The purpose of this study was to observe metformin enalapril on blood pressure, obesity, hypertension, body mass index （BMI）, waist circumference and lipids. Methods： 76 patients diagnosed as obesity-associated hypertension were randomly divided into treatment group and control group, 38 cases were treated with observation metformin ＋ enalapril; control group, 38 patients given enalapril treatment, observation period was 24 weeks. Before treatment and after treatment the lipids （TG, TC, HDL-C, LDL-C）, BMI, waist circumference （WC） change were measured. Outpatient follow-up every 2 weeks and record blood pressure. Results： （D After 24 weeks of treatment, metformin ＋ enalapril antihypertensive effect of the observation group was significantly better than enalapril group （P 〈0.05）; （2） observation group＇s body mass index （BMI）, waist circumference （WC）, Lipid levels decreased significantly compared with before treatment （P 〈0.05）, while the control group, no significant change compared with before treatment （P〉 0.05）. Conclusion： Metformin ＋ enalapril in obesity-associated hypertension patients not only has good anti-hypertension effects and can reduce the BMI, WC and lipid levels.