高胰岛素血症高血压病患者交感神经活性的研究

A study of sympathetic activity in hypertensive patientswith hyperinsulinemia

本研究对５５例高血压病（３５例高血压胰岛素抵抗，２０例高血压非胰岛素抵抗）和３０例正常人，进行糖耐量、胰岛素释放曲线及血浆儿茶酚胺水平的测定。结果显示：（１）高血压病人中６５％存在着高胰岛素血症及胰岛素抵抗。（２）高血压胰岛素抵抗组病人空腹血浆去甲肾上腺素（ＮＥ）水平明显高于高血压非胰岛素抵抗组及正常人组。（３）糖耐量后３组血浆ＮＥ水平均高于糖负荷前水平，以高血压胰岛素抵抗组增高更为明显。上述结果表明，高胰岛素血症的高血压患者交感神经活性明显增高，因它有拮抗胰岛素的作用，因此可以导致胰岛素抵抗的形成。反复交感神经活性激活，可引起血管结构的变化，从而加重高血压病，使胰岛素抵抗恶化。

Abstract Fifty five patients with essential hypertension(35with and 20 without insulin resistance)and 30 normal subjects were studied.The test included OGTT, IRT and levels of plasma catecholamine. The results showed:(1)Hypertensive patients had 65% hyperinsulinemia and insulin resistance.(2) The levels of plasma catecholamine-norepinephrine level in group of hypertensive patients with insulin resistance had significantly higher levels compared to group hypertensive patients without insulin resistance and group normal subjects before glucose loading.(3)The levels of catecholaminenorepinephine in three groups increased after glucose loading.The increase in the group of hypertensives with insulin resistance was much more obvious.The results indicate that the sympathetic nerve activities of hypertersive patients with hyperinsulinemia are greatly increased. The reason is that the increased sympathetic nerve activities counteract with insulin and lead to insulin resistance. Frequent activations of stimulated sympathetic nerve cause the changes of vascular structure, and cause the deterioration of hypertension and IR.