高血压伴胰岛素抵抗患者大动脉弹性改变及其影响因素

The changes and impact factors of big arterial elasticity in patients with insulin resistance-essential hypertension

目的探讨不同年龄和血压水平的高血压伴胰岛素抵抗患者肱踝脉搏波速度(BAPWV)的改变及其主要影响因素。方法将120例高血压患者依据胰岛素抵抗指数(HOMA-IR)分为伴胰岛素抵抗组60例和无胰岛素抵抗组60例)及116例健康人,应用动脉硬化检测仪自动测量右侧BAPWV。结果健康人和高血压患者BAPWV均随年龄增大而增加(P<0.05);高血压伴胰岛素抵抗患者BAPWV随血压水平升高而增高(P<0.05),高血压伴胰岛素抵抗患者较高血压无胰岛素抵抗患者的BAPWV值高(P<0.05);多元逐步回归分析显示,年龄、HOMA-IR和收缩压是影响高血压伴胰岛素抵抗患者BAPWV的独立因素。结论高血压伴IR患者动脉弹性较差;年龄、HOMA-IR和收缩压是影响高血压伴胰岛素抵抗患者大动脉弹性的主要危险因素。

Objective To analyze the changes of brachial - ankle pulse wave velocity in patients with insulin resistance - essential hypertension, and to analyze effects of age and blood pressure levels on these changes. Methods Pulse wave velocity （PWV） measuring system was applied to examine right brachial -ankle PWV （BAPWV） as the parameters reflecting central elastic large arterial elasticity. 120 patients hypertension were divided two groups （ Insulin resistance - essential hypertension and no - insulin resistance - essential hypertension） by insulin resistance. All patients with essential hypertension and 116 healthy subjects were recruited in the study. Results BAPWV increased with age in both groups （ P 〈 0.05 ） ; BAPWV increased with blood pressure in insulin resistance - essential hypertension patients （ P 〈 0.05 ）, BAPWV was higher in patients with insulin resistance - essential hypertension than that in no - insulin resistance - essential hypertension patients （ P 〈 0.05 ）, A stepwise multiple regression analysis demonstrated that age, HOMA - IR and systolic blood pressure （SBP） were positively related to BAPWV independently in Insulin Resistanceessential hypertension patients. Conclusion Age, HOMA - IR and SBP are the major risk factors on big arterial elasticity in insulin resistance - essential hypertension patients. Examining the change of large arterial elasticity has important clinical value in insulin resistance - essential hypertenslon patmnts.