胰岛素抵抗与高血压病及冠状动脉粥样硬化性心脏病关系的初步研究

Insulin-resistance, Hypertension and Coronary Heart Disease

目的:探讨胰岛素抵抗(IR)和高胰岛素血症(HIS)在高血压病和冠状动脉粥样硬化性心脏病(冠心病)之间有什么异同,以及HIS与左心室肥厚及心律失常的关系。方法:检测65例高血压病、61例冠心病及57例对照组的空腹血糖和胰岛素;3组间各有20例做葡萄糖耐量试验和胰岛素释放试验;高血压病组同时做动态心电图(Holter)和超声心动图检查。3组间比较采用t和U检验。结果:高血压病组和冠心病组空腹胰岛素显著增高(P<0.001);胰岛素释放试验中,2小时高血压病组胰岛素已明显降低.而冠心病组却持续增高(P<0.001);高血压病伴有HIS者左心室肥厚和心律失常的发生率则显著高于不伴HIS者(P<0.05)。结论:部分高血压病和冠心病患者存在IR和HIS,HIS可能参与了左心室肥厚的形成。

Objective; To compare the differences of insulin-resistance (IR) and hyperinsulinemia (HIS) between patients with hypertension (HTN) and coronary heart disease (CHD), and to test the hypothesis that the incidences of left ventricular hypertrophy and arrhythmia are associated with HIS. Methods: Fast blood glucose, serum insulin in HTN (n=65),CHD (n=61), and control (n=57) groups, OGTT and insulin release test in 20 patients from each group and Holter monitoring and UCG examination in HTN group were studied. Results: Fast serum insulin significantly increased in both HTN and CHD grodps (vs. controls, (p<0.001). During the insulin release test at 2h, serum insulin was higher in the CHD than in the HIN group (p<0.001). The incidences of left ventricular hypertrophy nad arrhythmia significantly increased in the HTN patients with HIS (vs. HTN with no HIS,p<0.05). Conclusion: Some of the cases in the HTN and CHD groups, are associated with IR and HIS, and HIS is possibly involved in the genesis of left ventricular hypertrophy.