原发性高血压胰岛素抵抗与抗心磷脂抗体相关性研究

Relationship between the insulin resistance of patients with essential hepertension and anticardiolipin antibodies

目的探讨原发性高血压病(EH)患者胰岛素抵抗(IR)与抗心磷脂抗体(ACA-IgG、ACA-IgM)、高敏C反应蛋白(hs-CRP)、内皮功能的关系。方法随机选取EH患者120例(检验组),体检健康者45名(对照组)。定量检测血清内皮素、胰岛素、血糖、ACA-IgG、ACA-IgM、hs-CRP水平。计算胰岛素敏感性指数(IAI),并测量血压。比较组间各指标的差异性并对ACA-IgG、ACA-IgM、hs-CRP和ET分别与IAI进行相关性检验。结果检验组血清IAI为-4.45±0.41(0.55)、内皮素(62.43±18.09)pg/ml、hs-CRP(3.68±1.35)mg/dl、ACA-IgG1.47±0.63、ACA-IgM1.64±1.49,较对照组-3.86±0.33(1.0)、(37.45±16.58)mg/dl、(1.19±0.76)mg/dl、0.87±0.29、1.01±0.56差异均有统计学意义(P<0.01和P<0.05)。相关性分析显示,检验组血清ACA-IgG、hs-CRP和ET水平分别与IAI呈显著负相关,相关系数分别为-0.34、-0.53和-0.44(P<0.05和P<0.01)。结论原发性高血压胰岛素抵抗与炎症状态、内皮功能紊乱相伴随,且与ACA-IgG呈显著负相关,提示高血压胰岛素抵抗患者存在血栓倾向。

Objective To investigate the correlation between the insulin resistance of patients with essential hypertension（EH） and endothelial function as well as the serum levels of anticardiolipin antibody（ACA- IgG,ACA-IgM）,high sensitive C-reactive protein （hs-CRP）. Methods 120 patients （test group）with EH and 45 healthy persons （control goup） were studied.Serum levels of ACA-IgG, ACA-IgM and endothelin （ET）, hs-CRP, glucose, insulin were measured and blood pressure were examined and insulin sensitivity index were calculated in everybodys. Comparing the difference of serum levels of ACA-IgG,ACA-IgM as well as insulin sensitivity index, hs-CRP,ET in test and control goup. Results The average serum levels of ET （62.43±18.09）mg/dl,hs-CRP （ 3.68± 1.35 ）mg/dl, ACA-IgG （ 1.47 ±0.63 ）, ACA-IgM （ 1.64± 1.49 ） and insulin sensitivity index -4.45 ±0.41 （ 0.55 ） in test group were significantly different than that of ET （37.45±16.58）mg/dl,hs-CRP （1.19±0.76）mg/dl,ACA- IgG （ 0.87 ±0.29 ）, ACA-IgM （ 1.01 ±0.56 ） and insulin sensitivity index -3.86 ±0.33 （ 1.0 ） in control group （P〈0.01 and P〈0.05 ）. The correlation analysis showed that serum levels of ACA-IgG, hs-CRP, ET were negative correlated with the insulin sensitivity index in test goup separately r=-0.34（P〈0.05）,r=-0.53（P〈0.01 ）, r=-0.44（P〈0.01 ）. Conclusion The insulin resistance of patiens with EH were accompany with dysfunction of endothelial and condition of inflammation, and were significantly negative correlated with the ACA-IgG. It was shown that insulin resistance of patients with EH were disposition of thrombus.