老老年原发性高血压患者餐后甘油三酯代谢与颈动脉粥样硬化的相关性

The correlation between the metabolism of postprandial triglyceride and atherosclerosis of carotid artery in old essential hypertension patients

目的观察空腹甘油三酯正常的老老年原发性高血压(Essential Hypertension,EH)患者进食脂肪餐后,是否存在餐后甘油三酯(Triglyceride,TG)的代谢异常,并探讨餐后高TG血症与颈动脉粥样硬化之间是否存在相关性。方法入选年龄>80岁、空腹TG水平正常的研究对象72例,将其分为3组,其中正常对照组22例,原发性高血压组(EH组)32例,原发性高血压伴体重超重组(EH伴超重组)18例。3组患者均进食脂肪餐,动态观察每组患者餐后2、4、6、8和10h的TG水平,并分别对3组患者行双侧颈动脉彩色多普勒检查,明确各组颈动脉粥样硬化程度。结果 EH组及EH伴超重组餐后各时点TG水平及餐后TG峰值均明显高于对照组,两组均存在TG清除时间向后明显延迟,且EH伴超重组较EH组更为明显,差异均有统计学意义(均P<0.05)。同时3组间颈动脉斑块发生率、颈动脉内膜中层厚度,EH伴超重组高于EH组,而EH组高于正常对照组,3组间差异均有统计学意义(均P<0.05)。结论老老年EH患者存在餐后TG代谢紊乱和清除延迟,合并体重超重者上述改变更为明显,且餐后TG的代谢障碍与颈动脉粥样硬化的发生发展存在内在联系。

Objective To explore whether old essential hypertension （EH） patients with normal fasting triglycer- ide have abnormal metabolism of postprandial triglyceride after a high-fat meal to investigate the relationship between postprandial hypertriglyceridemia and atherosclerosis of carotid artery. Methods 72 study objects older than 80-years with normal fasting triglyceride were divided into control groups （22 healthy subjects）, EH （32 patients） and EH pa- tients with overweight （18 patients）. The dynamical variation of postprandial triglyceride on 2h, 4h, 6h, 8h and 10h were observed. The color Doppler ultrasonography was applied to estimate the severity of atherosclerosis of carotid arter- y. Results Both the levels of postprandial triglyceride in different postprandial time points and the peak concentration of postprandial triglyceride in EH group and,EH with overweight group were significantly higher than those in the control subjects. The obliteration of postprandial triglyceride became more slowly in EH group and EH with overweight group. The above phenomenon was more obvious in EH with overweight group than in EH group, and there was significant differences between the two groups. The incidence of carotid artery plaque and carotid artery intima-media thickness were highest in EH with overweight group, and secondly in EH group. There were significant differences between the three groups. Conclusion The old hypertensive patients showed abnormal metabolism of postprandial triglyceride. After high - fat loading the decrease of TG was delayed in EH, the above phenomenon was more obvious in the hypertensive parents with overweight. These abnormal metabolism of postprandial triglyceride were closely related to carotid artery atheroscle- rosis.