老年高血压伴餐后高血糖患者炎性因子变化及阿卡波糖的干预

Intervention effect of acarbose on inflammatory factors in aged patients with hypertension accompanying postprandial hyperglycemia

目的观察高血压伴餐后高血糖患者炎性因子水平及阿卡波糖的干预效应。方法选择1级老年单纯收缩期高血压患者208例,根据是否伴餐后高血糖,将患者分为伴高血糖组89例和高血压组119例,同期选择健康体检者70例为对照组。采用胶乳免疫增强比浊法测定高敏C反应蛋白(hs-CRP),放射免疫法测定血清TNF-α、白细胞介素6(IL-6)。伴高血糖组患者阿卡波糖50 mg,3次/d,治疗1 2周后,再次检测3种血清炎性因子水平,并进行比较。结果高血压组和伴高血糖组hs-CRP、TNF-α和IL-6水平均高于对照组(P<0.05,P<0.01);伴高血糖组hs CRP、TNF-α和IL-6水平均高于高血压组(P<0.05)。hs CRP、TNFα和IL-6与血压、餐后2 h血糖呈正相关。与治疗前比较,阿卡波糖治疗后,患者hs-CRP、TNF-α和IL-6水平明显下降,差异有统计学意义(P<0.01)。结论老年高血压伴餐后高血糖患者炎性反应较单纯高血压者严重,阿卡坡糖可减轻炎性反应,延缓动脉粥样硬化进程。

Objective To observe the intervention effect of acarbose on inflammatory factors and postprandial hyperglycemia in aged patients with hypertension. Methods Two hundred and eight aged patients with grade 1 simple systolic hypertension were divided into hypertension accompanying postprandial hyperglycemia group（n= 89） and hypertension group（n= 119） according to their postprandial glucose level. Seventy persons undergoing healthy check-up served as a control group. High sensitive C reaction protein（hs-CRP） was detected by turbidimetry,TNF-α and IL-6 levels were measured by RIA. Serum levels of 3 inflammatory factors in the patients of hypertension accompanying postprandial hyperglycemia group were measured and compared 12 weeks after treated with acarbose at the dose of 50 rag（3 times a day）. Results The hs-CRP,TNF-α and IL-6 levels were significantly higher in hypertension group and hypertension accompanying postprandial hyperglycemia group than in control group（P〈0.05, P〈0.01）, and in hypertension accompanying postprandial hyperglycemia group than in hypertension group （P〈 0. 05）. The hs-CRP, TNF-α and IL-6 levels were positively related with blood pressure and 2-hour postprandial blood glucose level and significantly lower after acarbose treatment than before acarbose treatment（P〈 0.01）. Conclusion Inflammatory reaction is severer in patients with hypertension accompanying postprandial hyperglycemia than in those with simple hypertension, which can be alleviated with acarbose,thus delaying the atherosclerotic process.