高血压胰岛素抵抗对PIP、MMP-2及左室舒张功能的影响

Effects Of Essential Hypertension IR on PIP、MMP-2 And Left Ventricular Diastolic Function

目的探讨原发性高血压(EH)有、无胰岛素抵抗(IR)患者左室重构及舒张功能的变化。方法测定86例EH患者和45例体检健康者空腹血糖及胰岛素,并计算胰岛素敏感性指数(IAI),以≤对照组IAI均值(-3.72±0.32)的低限(-4.04)者46例作为IR组,非IR组40例。比较三组受试者心脏舒张功能指标:等容舒张时间(IVRT)、二尖瓣环舒张早期运动速度(Ea)/舒张晚期运动速度(Aa)比值;左室重构指标:血清前胶原羧基端肽(PIP)、金属蛋白酶-2(MMP-2)浓度。结果与对照组比较非IR组和IR组平均IVRT均明显延长、Ea/Aa比值均明显降低、血清PIP、MMP-2均显著升高(P<0.05和P<0.01);且与非IR组比较IR组平均IVRT和血清PIP、MMP-2进一步显著延长和升高,Ea/Aa比值进一步显著降低(P<0.05和P<0.01)。结论伴有IR的高血压患者较非IR高血压患者左室心肌重构更重、左室舒张功能更差。

Objective To investigate the transformation of Left ventricular remodeling and diastolic function of the essential hypertension（EH） patients combining with the insulin resistance（IR） or not . Methods 86 EH patients and 45 healthy persons were Measured the serum levels of glucose （FBG） and insulin （FINS） , and Calculated the insulin acute index（IAI）. IR group were divided into two groups ：according to the average level of IAI in healthy control （-3.72 ± 0. 32 ）, ≤the lowest level （-4. 04 ） 46 cases as the IR group , the others as the non-IR group. Analysed the data of three groups . Data reflect the heart diastolic function including IRVT , ratio of nitral annular velocity in early diastolie （Ea）and late diastolic （Aa）, data reflect left ventricular remodeling including serum level of carboxy-terminal peptide of procollagen type I （PIP） , Matrix Metalloproteinasas-2 （MMP-2）. Results Compared with control group , IVRT of non-IR group and RI group were markedly extended , E/A were markedly decreased , PIP , MMP-2 were markedly increased （P 〈 0. 05 and P 〈 0.01 ） ;And to compared with the non-IR group , IVRT , E/A, PIP MMP-2 were also markedly changed （P 〈 0. 05 and P 〈 0. 01 ）. Conclusion Combining with IR EH patients were more poor in left ventricular diastolic function and more serious in left ventricular remodeling than those without RI（non-RI） EH patients.