高血压伴胰岛素抵抗病人颈动脉血流动力学的研究  

Study of hemodynamics in common carotid artery in patients with hypertension and insulin resistance

作　　者：王旭开[1] 杜文华[1] 李陶[1] 杨成明[1] 付春江[1] 何作云[2] 王燕[3] 

机构地区：[1]第三军医大学大坪医院野战外科研究所心血管内科,重庆400042 [2]第三军医大学新桥医院心血管内科,全军心血管内科中心,重庆400037 [3]第三军医大学基础医学部分子遗传学教研室,重庆400038

出　　处：《第三军医大学学报》2004年第17期1564-1566,共3页Journal of Third Military Medical University

基　　金：国家自然科学基金资助项目 ( 30 170 384 )~~

摘　　要：目的　探讨高血压伴胰岛素抵抗颈动脉血流动力学及血管壁顺应性变化与动脉粥样硬化形成的关系。方法　选择原发性高血压 (EH)病人 48例 ,正常对照 49人。按胰岛素抵抗指数 (HOMA)分 3组 ,原发性高血压伴胰岛素抵抗[EHIR( +) ]组 ,原发性高血压无胰岛素抵抗 [EHIR( -) ]组 ,正常对照组 (NEH)。应用二维彩色超声诊断仪测定受检者颈动脉参数及临床生化指标 ,计算HOMA指数、CSDC、Vd Vs评估胰岛素抵抗颈动脉血流动力学及血管壁顺应性。结果　EHIR( +)组HOMA指数与IMT呈正相关 (r =0 3 8,P <0 0 1) ,CSDC与HOMA指数呈负相关 (r =-0 2 9,P <0 0 1) ,Vd Vs与HOMA指数呈负相关 (r =-0 3 1,P <0 0 1)。BMI、甘油三酯 (TG)水平高于EHIR( -)及NEH组 (P <0 0 5 )。高密度脂蛋白 (HDL C)水平及颈动脉斑块大小在EHIR( +)组明显低于EHIR( -)组 (P <0 .0 5 )。Objective To investigate the relationship of hemodynamics in common carotid artery (CCA) and changes in arterial vessel compliance with atherosclerosis in patients with hypertension and insulin resistance (IR). Methods A total of 48 patients with essential hypertension (EH) and 49 normotensive controls (NEH) were enrolled in this study. According to the homeostasis model assessment (HOMA) index, all subjects were classified into three groups: EH IR(+), EH IR(-), and NEH. Common carotid artery parameters were assessed with B mode ultrasound imaging. Results The IMT was positively correlated with the HOMA index in all subjects ( r =0 38, P <0 01). Vd/Vs and CSDC were significantly decreased in EH IR(+) as compared with those in NEH and EH IR(-).Vd/Vs and CSDC were negatively correlated with the HOMA index ( r =-0 31, P <0 01; r =-0 29, P <0 01). EH IR(+) had a higher body mass index and triglyceride level than EH IR(-) and NEH. EH IR(+) revealed a significantly lower level of HDL cholesterol than EH IR(-). Conclusion Decreased distensibility of the arterial wall and ensuing low diastolic perfusion are the possible mechanisms of atherosclerotic changes in the CCA in EH patients with IR.

关 键 词：胰岛素抵抗 动脉粥样硬化 原发性高血压 

分 类 号：R331.3[医药卫生—人体生理学] R458.5[医药卫生—基础医学]