中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2010年
8期
812-815
,共4页
原发性高血压%大动脉顺应性%胰岛素抵抗
原髮性高血壓%大動脈順應性%胰島素牴抗
원발성고혈압%대동맥순응성%이도소저항
Essential hypertension%Aortic compliance%Insulin resistance
目的 探讨胰岛素抵抗与原发性高血压(EH)患者大动脉顺应性的关系.方法 选取原发性高血压患者35例作为EH组,并选取性别、年龄、体重指数近似于EH组的血压正常的健康者35名作为正常对照组.均行血压测定和采用彩色多普勒超声心动图检测,并计算升主动脉压力应变弹性系数(EP)及动脉僵硬度(β)值作为反映大动脉顺应性的参数,采用氧化酶法测定空腹血糖(FPG),化学发光法测空腹胰岛素(FINS),计算胰岛素抵抗指数(HOMA-IR),2组进行比较研究.结果 EH组FINS为(10.15±1.03)mU/L,HOMA-IR为2.21±0.68,升主动脉EP为(250.79±85.52)kN/m2,升主动脉β值为15.60±7.55.正常对照组FINS为(6.80±3.05)mU/L,HOMA-IR为1.48±0.16,升主动脉EP为(183.90 4-64.65)kN/m2,升主动脉β值为10.86±4.92,2组比较差异均有统计学意义(t值分别为2.213、2.626、4.526和2.602,P均<0.05).EH组HOMA-IR与升主动脉EP、升主动脉β值均呈显著正相关(r值分别为0.558和0.601,P均<0.05).结论 原发性高血压患者存在大动脉顺应性减退及胰岛素抵抗,并且大动脉顺应性与胰岛素抵抗有明显相关性,与胰岛素抵抗相关的高胰岛素血症可能是促进原发性高血压患者发生大动脉重构的重要影响因素.
目的 探討胰島素牴抗與原髮性高血壓(EH)患者大動脈順應性的關繫.方法 選取原髮性高血壓患者35例作為EH組,併選取性彆、年齡、體重指數近似于EH組的血壓正常的健康者35名作為正常對照組.均行血壓測定和採用綵色多普勒超聲心動圖檢測,併計算升主動脈壓力應變彈性繫數(EP)及動脈僵硬度(β)值作為反映大動脈順應性的參數,採用氧化酶法測定空腹血糖(FPG),化學髮光法測空腹胰島素(FINS),計算胰島素牴抗指數(HOMA-IR),2組進行比較研究.結果 EH組FINS為(10.15±1.03)mU/L,HOMA-IR為2.21±0.68,升主動脈EP為(250.79±85.52)kN/m2,升主動脈β值為15.60±7.55.正常對照組FINS為(6.80±3.05)mU/L,HOMA-IR為1.48±0.16,升主動脈EP為(183.90 4-64.65)kN/m2,升主動脈β值為10.86±4.92,2組比較差異均有統計學意義(t值分彆為2.213、2.626、4.526和2.602,P均<0.05).EH組HOMA-IR與升主動脈EP、升主動脈β值均呈顯著正相關(r值分彆為0.558和0.601,P均<0.05).結論 原髮性高血壓患者存在大動脈順應性減退及胰島素牴抗,併且大動脈順應性與胰島素牴抗有明顯相關性,與胰島素牴抗相關的高胰島素血癥可能是促進原髮性高血壓患者髮生大動脈重構的重要影響因素.
목적 탐토이도소저항여원발성고혈압(EH)환자대동맥순응성적관계.방법 선취원발성고혈압환자35례작위EH조,병선취성별、년령、체중지수근사우EH조적혈압정상적건강자35명작위정상대조조.균행혈압측정화채용채색다보륵초성심동도검측,병계산승주동맥압력응변탄성계수(EP)급동맥강경도(β)치작위반영대동맥순응성적삼수,채용양화매법측정공복혈당(FPG),화학발광법측공복이도소(FINS),계산이도소저항지수(HOMA-IR),2조진행비교연구.결과 EH조FINS위(10.15±1.03)mU/L,HOMA-IR위2.21±0.68,승주동맥EP위(250.79±85.52)kN/m2,승주동맥β치위15.60±7.55.정상대조조FINS위(6.80±3.05)mU/L,HOMA-IR위1.48±0.16,승주동맥EP위(183.90 4-64.65)kN/m2,승주동맥β치위10.86±4.92,2조비교차이균유통계학의의(t치분별위2.213、2.626、4.526화2.602,P균<0.05).EH조HOMA-IR여승주동맥EP、승주동맥β치균정현저정상관(r치분별위0.558화0.601,P균<0.05).결론 원발성고혈압환자존재대동맥순응성감퇴급이도소저항,병차대동맥순응성여이도소저항유명현상관성,여이도소저항상관적고이도소혈증가능시촉진원발성고혈압환자발생대동맥중구적중요영향인소.
Objective To study the association of insulin resistance ( IR ) with aortic compliance impairment in patients with essential hypertension (EH). Methods Thirty-five patients with EH and 35 healthy control subjects were enrolled. The two groups were matched by sex, age and weight Blood pressure was measured and high resolution color Doppler examination was performed. Pressure-strain elastic modulus ( EP) and stiff index were calculated to reflect the change of aortic compliance in all subjects. Fasting plasma glucose (FPG) was assayed with oxidase technique, serum fasting insulin ( Fins) was assayed with chemoluminescent technique, Calculate insulin resistance index (HOMA-IR) was calculated using FPG and FINS. Results In the EH group, Fins, HOMA-IR and EP of ascending aorta were ( 10. 15 ± 1.03) mU /L, 2. 21 ± 0. 68, (250. 79 ± 85. 52 ) kN/m2, respectively,and the stiff index( β) was 15. 60 ±7. 55. In the control group, Fins,HOMA-IR, EP and stiff index β were (6. 80 ± 3. 05) mU/L, 1. 48 ± 0. 16, (183. 90 ± 64. 65 ) kN/m2 and 10. 86 ± 4. 92, respectively. There were significant difference on these above mentioned indices between the two groups (P < 0. 05 ). In the EH group, HOMA-IR were positively correlated with the ascending aorta EP and stiff index β ( r = 0.558 and 0.601 respectively, P < 0. 05 ). Conclusions Aortic compliance impairment and IR are found in patients with EH. There is significant association of IR with aortic compliance impairment Hyperinsulinemia related to insulin resistance might be an important influential factor which promote large artery remodeling in patients with EH.
