高血压病人颈动脉缓冲功能与胰岛素抵抗关系的探讨

Relationship between buffer function of carotid and insulin resistance in patients with hypertension

目的 探讨高血压病人颈动脉扩张性与胰岛素敏感性的变化 ,及高血压病人颈动脉缓冲功能与胰岛素抵抗是否相关。方法 选取原发性高血压病人 5 4例 ( EH组 ) ,健康志愿者 47例 ( HM组 ) ,应用二维超声评估颈动脉缓冲功能 ,应用胰岛素敏感指数评估胰岛素敏感性水平。结果 EH组收缩压、舒张压、脉压、平均动脉压、空腹血清胰岛素和葡萄糖较 HM组显著升高 ( P<0 .0 1)。EH组颈动脉扩张性、胰岛素敏感指数较 HM组显著降低 ( P<0 .0 1)。胰岛素敏感指数、空腹血清胰岛素与高血压病人颈动脉扩张性密切相关 ( P<0 .0 1)。胰岛素敏感指数、空腹血清胰岛素、脉压、年龄、平均动脉压、空腹血清葡萄糖 ,与高血压病人颈动脉扩张性降低显著相关。其中胰岛素敏感指数和空腹血清胰岛素与高血压病人颈动脉扩张性降低的相关性尤为密切。结论 高血压病人颈动脉扩张性及胰岛素敏感性水平较健康人显著降低。高血压病人颈动脉缓冲功能与胰岛素敏感指数。

Objective To investigate the changes of carotid disensibility and insulin sensitivity and to evaluate relations of insulin resistance (IR) to buffer function of carotid in patients with hypertension. Methods 54 essential hypertension patients (EH group) and 47 healthy men (HM group) were observed. Buffer function of carotid were assessed with high-resolution B-mode ultrasonography. Insulin sensitivity index(ISI)=1/(FINS^FSG), which FINS and FSG standed for fast serum insnlin and glucose, respectirely, was used to evaluate insulin resistance level. Results Systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), Mean arterial pressure (MAP), fast serum insulin (FINS), fastserum glucose (FSG) were higher in EH group than HM group ( P <0.01), arterial distensibility (AD) and ISI were lower in EH group than HM group ( P <0.01). FINS was negative carotid AD and ISI was positively related to carotid AD in EH group( P <0.01). ISI, FINS, PP, Age, MAP and FSG were main factors that influence carotid distensibility. The change of AD was closely related to ISI and FINS. Conclusion Carotid distensibility and insulin sensitivity level decreased in hypertension patients. The change of carotid distensibility of hypertension patients had close relationship with both levels of insulin sersitivity and blood pressure.