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[当代血管紧张素转换酶抑制剂莫昔普利和螺普利对绝经后代谢综合征女性的疗效及安全性比较]

[Comparative efficacy and safety of contemporary Angiotensin converting enzyme inhibitors moexipril and spirapril in women with postmenopausal metabolic syndrome].

作者信息

Leonova M V, Demidova M A, Tarasov A V, Belousov Iu B

出版信息

Kardiologiia. 2006;46(1):43-9.

Abstract

Moexipril (7.4-15 mg/day) was given to 34, spirapril (3-6 mg/day) -- to 18 postmenopausal women with hypertension and metabolic syndrome for 16 weeks. Hydrochlorthiazide was added when therapy was not sufficiently effective. Both angiotensin converting enzyme inhibitors had similar hypotensive activity: blood pressure normalized in 71 and 61% of moexipril and spirapril treated women, respectively. Both drugs promoted normalization of metabolism of lipid (lowering of levels of cholesterol, atherogenic lipoproteins and triglycerides) and carbohydrates (lowering of hyperinsulinemia). Patients with postmenopausal metabolic syndrome had elevation of leptin level up to 27.5+/-5.5 pg/ml. Moexipril and spirapril caused lowering of elevated levels of leptin. These drugs did not affect levels of sex hormones. They exerted vasoprotective (normalization of endothelium dependent and independent vasodilatation) and nephroprotective (attenuation and normalization of microalbuminuria) effects. Thus spirapril and moexipril are effective in treatment of hypertension in patients with postmenopausal metabolic syndrome.

摘要

对34名绝经后高血压合并代谢综合征的女性给予莫昔普利(7.4 - 15毫克/天),对18名给予螺普利(3 - 6毫克/天),治疗16周。治疗效果欠佳时加用氢氯噻嗪。两种血管紧张素转换酶抑制剂具有相似的降压活性:接受莫昔普利和螺普利治疗的女性中,血压分别在71%和61%的患者中恢复正常。两种药物均促进脂质代谢(降低胆固醇、致动脉粥样硬化脂蛋白和甘油三酯水平)和碳水化合物代谢(降低高胰岛素血症)正常化。绝经后代谢综合征患者的瘦素水平升高至27.5±5.5皮克/毫升。莫昔普利和螺普利可使升高的瘦素水平降低。这些药物不影响性激素水平。它们具有血管保护作用(使内皮依赖性和非依赖性血管舒张恢复正常)和肾保护作用(减轻并使微量白蛋白尿恢复正常)。因此,螺普利和莫昔普利对绝经后代谢综合征患者的高血压治疗有效。

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