原发性高血压病人的甘油三酯水平与空腹胰岛素、自由基代谢及凝血/纤溶活性关系的研究

Study on the Relationship between Insulin, Free Radical Metabolism as well as Coagulant/Fibrinoltic Activity and Triglyceride in Patients With Primary Hypertension

目的 研究高血压病人甘油三酯(TG)和空腹胰岛素(INS)、自由基代谢及凝血/纤溶活性的关系。方法 以未治疗的高血压病人空腹血清TG大于1.8mmol/L为Ⅰ组,TG小于或等于1.8mmol/L为Ⅱ组,比较两组的INS、胰岛素敏感指数(ISI)及其丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、内皮素(ET)、一氧化氮(NO)、血小板α-颗粒膜蛋白(GMP-140)、组织型纤溶酶原激活剂(t-PA)及其抑制剂(PAI)等指标的差异。结果 Ⅰ组的 TG、INS、ET、MDA、PAI、GMP-140均高于Ⅱ组,而ISI、NO、SOD、GSH-Px、t-PA均较之为低,均P<0.05或P<0.01。结论 高血压病人伴高甘油三酯血症存在着较明显的胰岛素抵抗、脂质过氧化反应增强、抗氧化酶活性降低、血管内皮细胞功能障碍、血小板活化、纤溶活性降低等现象,重视高血压病人伴高甘油三酯血症的治疗有助于减少其他心血管疾病及其并发症的发生。

Objective To study the relationship between insulin (INS),free radical metabolism as well as eoagulant/fibrinolyt-ic activity and triglyceride (TG)in patients with primary hypertension. Methods Fasting serum INS, malonyldialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidation (GSH- Px),endothelin (ET), nitric oxide (NO), tissue plasminogen (t-PA) , plasminogen activator inhibitor (PAI), α-granule membrane protein-140 (GMP-140)levels were measured, and INS index (ISI) was calculated in 83 patients. According to the levsl of TG, they were divided into two groups: 61 with hypertriglyceridemia (group Ⅰ, TG >1.8mmol/L)and 22 with normal TG( <1.8mmol/L, group Ⅱ). Results The levels of ET, MDA, PAI, GMP - 140 were obviously higher and ISI, NO, SOD, GSH - Px, t - PA were lower in group Ⅰ than those in group Ⅱ , all P < 0.05 或 P < 0.01. Conclusion Insulin resistance, Lipid peroxidation enlianced, activity of antioxidative enzyme declined, vascular endothelial cells damaged and platelet activatdand as well as fibrinolyn'c activity reduced are more marked in group Ⅰ , the earlier we treat hypertriglyceridemia in patients with primary hypertension, the more occurrence of other cardiovascular disease and its complication being reduced.