老年原发性高血压患者高敏C反应蛋白与胰岛素抵抗  

High-sensitive C-reactive protein and Insulin Resistance in Elderly Hypertension Patients

作　　者：谢建洪[1] 黄惠玲[1] 张丽[1] 黄慧芳[1] 

机构地区：[1]浙江省人民医院高血压科,浙江杭州310014

出　　处：《中华高血压杂志》2008年第7期643-645,共3页Chinese Journal of Hypertension

摘　　要：目的探讨老年高血压患者高敏 C 反应蛋白(hsCRP)与胰岛素抵抗(IR)的关系。方法入选260例老年高血压患者(HT 组)、230例老年高血压合并2型糖尿病患者(HT+DM 组)和250名健康体检者(对照组),3组患者进行动态血压、血空腹血糖(FPG)、空腹胰岛素(FINS)、血管性假血友病因子(vWF)、hsCRP 检测。结果 HT 组及 HT+DM 组 FINS、FPG、vWF、hsCRP、收缩压(SBP)、舒张压(DBP)均显著高于对照组(P 均<0.01);胰岛素敏感指数(IAD 显著低于对照组(P 均<0.01)。相关分析显示 hsCRP 与 FINS、vWF 和血压呈明显正相关,与 IAI 显著负相关(r=-0.385,P<0.01),当控制 SBP、DBP、FINS、vWF 4个因素后,hsCRP 与 IAI 作偏相关分析,两者仍呈明显负相关(r=-0.376,P<0.01)。结论老年高血压患者中血清 hsCRP 含量与胰岛素抵抗和内皮功能紊乱标志因子密切相关。Objective To investigate the relationship between high-sensitive C-reactive protein（hsCRP）and insulin resistance（IR）in elderly hypertension patients. Methods The levels of ambulatory blood pressure monitoring（ABPM）, fasting plasma glucose （ FPG）, fasting insulin （ FINS）, von Willebrand factor （vWF）, hsCRP were measured in elderly patients with hypertension alone（n= 260）, hypertension coexit with diabetes（n= 230）, and healthy matched subjects（n=250）. Results The levels of FINS, FPG, vWF, hsCRP, systolic blood pres- sure（SBP）, diastolic blood pressure（DBP）in the HT and HT ＋DM group were significantly higher than that in the NC group（P（0.01）with lower insulin sensitivity index（IAI） （P（0.01）. The correlation analysis showed that hsCRP, FPG, FINS, vWF were positively correlated with blood pressure, negatively associated with IAI（r= --0. 385, P（0.01）. After adjusting for SBP, DBP, FINS and vWF, hsCRP remained negatively associated with IAI（ （r=- 0.376, P〈0. 01）. Conclusion Serum hsCRP in elderly hypertension patients is significantly associated with insulin resistance and marker of the dysfunction of endothelial cell.

关 键 词：高血压 胰岛素抵抗 高敏C反应蛋白 血管性假血友病因子 

分 类 号：R544.1[医药卫生—心血管疾病] R473.5[医药卫生—内科学]