老年高血压患者胰岛素抵抗与左心室结构左心功能的关系

A study of relationship between insulin resistance and left ventricular hypertrophy in elderly hypertensives

目的探讨老年高血压患者胰岛素抵抗对左心室结构和左心功能的影响。方法96例老年男性高血压患者,分为老年高血压组(EH)和老年高血压合并左心室肥厚(EH+LVH)组,与90例老年正常血压者比较,检测葡萄糖和胰岛素曲线下面积,胰岛素敏感指数,同时观测左心室结构,左心收缩和舒张功能。总外周血管阻力,并作相关性分析。结果与EH组及正常血压组比较,EH+LVH组的左心室重量指数升高,左心室舒张功能下降,胰岛素敏感指数下降,有显著差异(P<0.05)。血清胰岛素水平与左心室舒张功能显著负相关,胰岛素敏感指数与左心室重量指数,左心室后壁厚度和总心室壁厚度显著负相关。(P<0.05-0.001)。结论老年高血压患者的胰岛素抵抗可促进心肌肥厚发生,并使心室舒张功能下降,应重视胰岛素抵抗的治疗。

Objective To study the relationship between left ventricular hypertrophy and insulin resistance in elderly hypertensives. Methods 96 male hypertensives and 90 healthy controls were included. Elderly male with hypertension were classified as essential hypertension group(group EH) and hypertension with left ventricular hypertrophy group(group EH + LVH). The area under glucose ,insulin release curve,insulin allergy index,left ventricular structure and function were determined. Statistics analysis was performed. Results The left ventricular mass index in group( EH + LVH) was obviously higher than those in the control group and EH group. The left ventricular diastolic function、 insulin allergy index were obviously lower in group EH. The insulin level in blood reversely related with diastolic function of left ventricle. Insulin allergy index significantly negative correlated with left ventricular mass index and total heart ventricular thickness ( P < 0. 05 - 0. 001 ). Conclusions Insulin resistance can accelarate heart hypertrophy and injure left ventricular diastolic function in elderly hypertensives. The treatment of insulin resistance must be addressed.