目的 评价阿利沙坦酯对轻度高血压合并糖调节受损患者血清炎症因子、颈动脉内膜中层厚度以及心血管事件发生率的影响。方法 选择2019年3月—2020年2月在南方医科大学附属佛山医院就诊的门诊或住院86例轻度高血压合并糖调节受损患者，随机分为对照组（41例）和治疗组（45例）。对照组主要给予饮食控制以及生活方式指导；治疗组除饮食控制以及生活方式指导外，同时清晨空腹阿利沙坦酯片，240 mg/次，1次/d，持续服药6个月。比较治疗前后两组患者心血管事件、临床疗效、炎症因子及颈动脉内膜中层厚度。结果 治疗后，治疗组患者收缩压（SBP）、舒张压（DBP）较治疗前显著降低（P<0.05）；且治疗后治疗组血压低于对照组（P<0.05）。治疗后，治疗组患者总胆固醇（TC）水平较治疗前显著降低（P<0.05）；治疗后治疗组TC水平低于对照组（P<0.05）。治疗后，治疗组患者空腹血糖（FPG）和餐后2 h血糖（2 h PG）较治疗前显著降低（P<0.05）；且治疗后治疗组血糖水平显著低于对照组（P<0.05）。治疗后，治疗组患者血清白细胞介素6（IL-6）、超敏C反应蛋白（hs-CRP）及颈动脉内膜中层厚度较治疗前均明显降低（P<0.05）；治疗后治疗组炎症因子及颈动脉内膜中层厚度低于对照组（P<0.05）。结论 阿利沙坦酯除有效控制轻度高血压外，还可以增强胰岛素敏感性，且有一定的抗炎和抗动脉粥样硬化作用，对于轻度高血压合并糖调节受损患者早期使用阿利沙坦酯，有助于减少心血管事件的发生。

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

广东省医学科研基金项目（A2017550）