原发性高血压和肾血管性高血压患者的胰岛素敏感性  

Insulin Sensitivity in Patients with Primary and Renovascular Hypertension

作　　者：林金秀[1,2] 陈达光[1,2] 郑舒亮 黄端[1,2] 

机构地区：[1]福建医科大学附属第一医院 [2]福建省高血压研究所

出　　处：《高血压杂志》1997年第3期196-198,共3页Chinese Journal of Hypertension

摘　　要：目的探讨肾血管性高血压和原发性高血压与胰岛素敏感性之间的关系。方法用正常血糖胰岛素钳夹技术测定２４例正常血压者、３８例高血压患者、１４例肾血管性高血压患者的葡萄糖代谢率（Ｍ），以Ｍ值作为胰岛素敏感性指标。结果高血压患者的Ｍ值明显低于正常血压及肾血管性高血压患者（５．４６±１．７８比９．３４±１．１４，８．６７±１．３７ｍｇ／ｋｇ·ｍｉｎ－１，Ｐ＜０．０１），正常血压与肾血管性高血压组之间差异无显著性（Ｐ＞０．０５）。高血压患者的胰岛素敏感性降低发生率显著高于正常血压及肾血管性高血压组（５８．８％比８．３％和７．１％，Ｐ＜０．０１），而正常血压与肾血管性高血压组之间无差异（Ｐ＞０．０５）。高血压患者Ｍ值与收缩压、平均动脉压高度相关（ｒ分别为－０．５０６，－０．４１４，Ｐ分别小于０．０１和０．０５），正常血压者和肾血管性高血压患者的Ｍ值与收缩压、平均动脉压无明显相关（正常血压：ｒ分别为－０．３６６和－０．３０１，Ｐ＞０．０５；肾血管性高血压：ｒ分别为－０．３１６和－０．３２４，Ｐ＞０．０５）。结论胰岛素敏感性降低可能是原发于高血压，而非继发于血压增高；测定胰岛素敏感性可作为高血压和肾血管性高血压的鉴别诊断参考指?Aim\ In order to investigate the relationships between insulin sensitivity(IS) and essential hypertension(HT),renovascular hypertension(RVH).\ Methods\ IS of normal subjects(NS,n=24),HT(n=38) and RVH(n=14) was quantified using euglycemic insulin clamp technique(EICT),glucose metabolism rate(M) was takens as index of IS.\ Results\ (1)M value in HT was significantly lowered compared to that in NS and RVH(5 46±1 78 vs 9 34±1 14 and 8 67±1 37 mg/kg·min -1 , P< 0 01), no significant different of IS between NS and RVH(P>0 05).(2)A significant correlation has been found between M value and SBP, mean blood pressure(MBP) in patients with HT(r=-0 506, -0 414,P<0 01 and 0 05 respectivily), however, no significant correlation in NS and RVH(NS:r=-0 366 and -0 301 respectivily,P>0 05; RVH:r=-0 316 and -0 324 respectivily,P>0 05).\ Conclusion\ These data suggest that decreased insulin sensitivity may be from the essential hypertension, is not followed by blood pressure increasing;insulin sensitivity measureed may act as one of method in differentiating essential hypertension and renovascular hypertension.

关 键 词：肾血管性高血压 高血压 胰岛素敏感性 

分 类 号：R544.102[医药卫生—心血管疾病]