高血压病患者的胰岛素抵抗及与动态血压的关系

Insulin resistance in patients with essential hypertension and the correlation between hyperinsulinemia and ambulatory blood pressure

我们用葡萄糖耐量试验对３３例Ⅱ期、Ⅲ期高血压病患者和２５例正常对照者的研究发现：口服葡萄糖后３０ｍｉｎ、６０ｍｉｎ、１２０ｍｉｎ和１８０ｍｉｎ时前者的血糖浓度显著高于后者（Ｐ＜０．０２，Ｐ＜０．０１，Ｐ＜０．００５，Ｐ＜０．００５）。空腹、服糖后１２０ｍｉｎ、１８０ｍｉｎ时前者的血清胰岛素浓度显著高于后者（Ｐ＜０．０５，Ｐ＜０．０１，Ｐ＜０．０２），这是典型的胰岛素抵抗。高血压病患者空腹血胰岛素浓度及胰岛素曲线下面积与动态的收缩压、舒张压、平均动脉压呈线性正相关。

Abstract Thirty three subjects with second to third stages of essential hypertension and 25 normotensive subjects were selected for study. OGTT (Oral glucose tolerance test) and serum insulin were tested for the presence of insulin resistance. It was found that the hypertensive persons had higher serum glucose levels at 30 to 180 minutes than did normotensive persons (P<0. 02, P<0.01 P<0. 005 , P<0. 005 ). The serum insulin levels in the former was markedly higher than in the latter at baseline and 120 to 180 minutes (P<0. 05 , P<0.01 ,P<0. 02). It is suggested that there is typical insulin resistance in hypertensive patients. Baseline serum insulin level and area under insulin curve correlated to ambulatory systolic , diastolic and mean arterial pressure in hypertensive patients.