高血压肾病与肾性高血压胰岛素抵抗的临床研究

A CLINICAL OBSERVATION OF INSULIN RESISTANCE IN PATIENTS WITH HYPERTENSIVE NEPHROSCLEROSIS AND RENAL HYPERTENSION

目的 探讨高血压肾病及肾性高血压与胰岛素抵抗 (IR)的关系 ,判定IR的程度。②方法 测定2 9例原发性高血压肾功能正常者 ,30例高血压肾病肾衰竭者 ,2 5例肾性高血压肾功能正常者 ,2 8例肾性高血压肾衰竭者及 2 2例正常人的空腹血糖和血浆胰岛素 ,计算胰岛素敏感指数。③结果 原发性高血压肾功能正常病人、高血压肾病肾衰竭者及肾性高血压肾衰竭者胰岛素浓度均高于正常对照组 ,差别具有显著性 (F =6 .2 7,q =3.0 6～9.48,P <0 .0 5 ,0 .0 1) ,胰岛素敏感指数降低 (F =7.45 ,q =3.5 7～ 10 .6 0 ,P <0 .0 5 ,0 .0 1) ;其中高血压肾病肾衰竭组胰岛素浓度亦高于原发性高血压肾功能正常组及肾性高血压肾衰竭组 ,差别具有显著性 (F =6 .2 7,q =3.2 5 ,3.92 ,P <0 .0 5 ) ,胰岛素敏感指数亦低于后两组 (F =7.45 ,q =3.6 2 ,4.18,P <0 .0 5 )。④结论 原发性高血压肾功能正常者、高血压肾病肾衰竭者及肾性高血压肾衰竭者均存在IR 。

Objective\ To study the relationship between insulin resistance(IR) and hypertensive nephrosclerosis and renal hypertension and determine the degree of insulin resistance. \ Methods\ Fasting serum glucose and serum insulin levels were detected and insulin sensitivity index calculated in 29 essential hypertensive with normal renal function, 30 renal failure due to hypertensive nephrosclerosis, 25 renal hypertensive with normal renal function ,28 renal failure due to renal hypertension and 22 normal control subjects.\ Results\ Comparing with the normal control, the serum insulin level in essential hypertensive, hypertensive nephrosclerosis and renal hypertensive were increased significantly( F=6.27,q=3.06-9.48,P <0.05,0.01),but the insulin sensitivity index markedly decreased ( F=7.45,q=3.57-10.60,P <0.05,0.01). Comparing with essential hypertensive with normal renal function and renal failure caused by renal hypertension, the insulin level in renal failure caused by hypertensive nephrosclerosis was also increased very significantly ( F=6.27,q=3.25,3.92,P <0.05),and the insulin sensitivity index markedly decreased ( F=7.45,q=3.62,4.18,P <0.05).\ Conclusion\ IR was presented in patients with essential hypertensive with normal renal function and renal failure caused by hypertensive nephrosclerosis and renal failure caused by renal hypertension .The degree of IR in patients with renal failure caused by hypertensive nephrosclerosis was relatively severe.