高血压病患者vWF及胰岛素抵抗与中医证型的关系

The Relationship Among Plasma vWF Insulin Resistance and TCM Syndromes in Hypertension

目的:探讨高血压病患者血管性血友病因子(vWF)及胰岛素抵抗(IR)与中医证型之间的关系。方法:将124例高血压患者进行中医辨证分型,测定BMI、血压、空腹血糖、空腹胰岛素、血浆vWF,同时计算IR的程度,IR采用HOMA-IR,并对vWF及IR进行相关分析。结果:患者空腹胰岛素水平在各证型之间存在显著差异,肝火亢盛组显著高于阴虚阳亢组及痰湿壅盛组(P<0.01);肝火亢盛组IR显著高于痰湿壅盛组(P<0.01),各组间IR水平为肝火亢盛组>阴阳两虚组>阴虚阳亢组>痰湿壅盛组;高血压病患者阴阳两虚组血浆vWF水平显著高于其他3组,且vWF与年龄呈正相关(R=0.308,P<0.01)。年龄每上升1岁,vWF水平上升0.978Mu/mL。结论:高龄高血压患者可能存在血管内皮损伤,更易血栓形成;肝火亢盛组IR最高,提示有明显的糖代谢紊乱。

Objective：To discuss the relationship among plasma vWF,insulin resistance and TCM syndromes in hypertension.Methods：One hundred and twenty-four patients with hypertension were selected and differentiated TCM syndromes.BMI,BP,fasting blood-glucose,fasting insulin and plasma vWF were detected.IR is evaluated by fasting blood-glucose value and fasting insulin level.The correlation of vWF with IR is analyzed.Results：There exists significant difference among the patients＇ fasting insulin level in different TCM syndromes.Compared with hyperactivity of yang due to yin deficiency type and the stagnation of phlegm-dampness type,fasting insulin level in hyperactivity of liver-yang type is significantly higher（P0.01）.IR in hyperactivity of liver-yang type is significantly higher than that in stagnation of phlegm-dampness type（P0.01）.The sequence of IR in four types is hyperactivity of liver-yang type deficiency of both yin and yang type hyperactivity of yang due to yin deficiency type stagnation of phlegm-dampness type.The deficiency of both yin and yang type has a higher vWF level than that in other three types.Plasma vWF level correlated with age（R=0.308,P0.01）.Conclusion：The increase of vWF in old hypertensive patients indicated endothelial repair and thrombus.The increase of IR in hyperactivity of liver-yang type group indicated glycemia and metabolic disorder.