高血压病患者胰岛素水平及钠钾泵、钙泵活性改变

Changes of plasma insulin level, erythrocyte membrane Na^+-K^+- and Ca~[2+)-Pump activities in hypertension

对２２例未经治疗的高血压病患者和２８例对照者进行口服葡萄糖耐量试验（ＯＧＴＴ）血糖、血胰岛素水平、红细胞膜钠钾泵、钙泵活性的测定。结果显示，糖耐量正常或异常的高血压病患者和各自对照组相比存在明显高胰岛素血症，钠钾泵或钙泵活性明显降低；多元相关分析表明去除年龄、肥胖、血糖因素下收缩压（ＳＢＰ）和餐后３０ｍｉｎ胰岛素及其面积呈正相关，舒张压（ＤＢＰ）和餐后３０ｍｉｎ、１２０ｍｉｎ胰岛素水平及其面积呈正相关，相关分析还发现ＳＢＰ、ＤＢＰ和钠钾泵、钙泵活性呈负相关，这些泵活性和胰岛素间存在明显负相关。本结果表明胰岛素不依赖于年龄、肥胖、血糖值与高血压病独立相关。胰岛素抵抗及（或）高胰岛素血症可能通过影响细胞膜钠钾泵、钙泵活性而致高血压。

Abstract Plasma glucose, insulin levels at fasting and following an oral glucose load (75g), erythrocyte membrane Na+-K+-and Ca2+-pump activities of 22 untreated patients with essential hypertension and 28 controls were measured. As compared with controls, the hypertensives with normal or impaired glucose tolerance (NGT or IGT) had hyperinsulinemia, decreased activity of Na+-K+- or Ca2+-pump. Ry multivariant analysis, after correction for age, BMI and plasma glucose level,both systolic pressure (SBP) and diastolic pressure (DBP) correlated positively with insulin level. Both Na+-K+-and Ca2+-pump correlated negatively with insulin level. The results demonstrated that the correlation of insulin with hypertension is independent of other factors such as age, obesity and plasma glucose, and the decrease of Na+-K+-and Ca2+-pump activities caused by insulin resistance and/or hyperinsulinemia might be related to the development of hypertension.