Tei指数及B型利钠肽评价高血压伴胰岛素抵抗患者心功能的初步研究  

Preliminary Study on Left Ventricular Function Evaluated by Tei Index and B-type Natriuretic Peptide in Hypertensive patients with Insulin Resistance

作　　者：蒋晖[1] 熊峰[1] 唐炯[1] 余秀琼[1] 戴玫[1] 王引利[1] 陈丽[1] 李妮[1] 

机构地区：[1]四川省成都市第三人民医院心内科,610031

出　　处：《中国医疗前沿》2010年第14期17-18,13,共3页China Healthcare Innovation

摘　　要：目的检测伴有胰岛素抵抗(IR)的高血压患者早期心功能状态,初步探讨Tei指数和B型利钠肽(BNP)评价此类患者心功能状况的临床价值。方法选取高血压伴IR患者30例,另选取不伴IR的高血压患者30例作为对照组。测定血浆脑钠肽水平、空腹血糖及空腹胰岛素水平,计算胰岛素抵抗指数(HomaIR)及胰岛素敏感指数(ISI),行超声心动图检查,计算Tei指数。结果①IR组与对照组相比,NT-proBNP差异无统计学意义(p>0.05),Tei指数及HomaIR显著增加(p<0.01),ISI显著降低(p<0.01);②Pearson相关分析显示:BNP与HomaIR、ISI、Tei指数均无明显相关性,r值分别为0.019(p>0.05)、0.016(p>0.05)、0.004(p>0.05)。Tei与HomaIR呈明显正相关,r值为0.344(p=0.008),Tei与ISI呈明显负相关,r值为-0.319(p=0.015)。结论高血压伴IR患者在左室收缩功能尚未发生改变时就可出现左室舒张功能障碍,Tei指数能敏感反映左室整体功能,且不易受外界因素的干扰,适宜早期评估高血压伴IR患者的整体心功能。Objective To explore the clinical value of Tei index and B-type natriuretic peptide （BNP） in assessment of left ventricular function in hypertensive patients with insulin resistance （IR）.Methods 30 hypertensive patients with IR and 30 hypertensive controls were examined by echocardiography.Other parameters including fasting serum glucose, fasting insulin and plasma BNP level.Tei index, Insulin resistance index （Homa IR） and insulin sensitivity index （ISI） were calculated according to the appropriate formula.Results ①There is no statistical significance between IR patients and controls （p〈0.05）.Tei index and Homa IR were significantly increased in IR patients compared to controls （p〈0.01） while ISI was significantly reduced （p〈0.01）.②Bivariate analysis confirmed that Tei index was positively correlated with Homa IR （r=0.344, p=0.008）, and negatively correlated with ISI （r=-0.319, p=0.015）, there was no correlation between plasma BNP and Homa IR, BNP and ISI or BNP and Tei index （r=0.019, 0.016, 0.004, all p〉0.05）.Conclusion Tei index can react the general heart function sensitively and has a good correlation between Homa IR, so it is a appropriate index to evaluate the early heart function of hypertensive patients with IR.

关 键 词：高血压 胰岛素抵抗 超声心动描记术 B型利钠肽 TEI指数 心脏功能 

分 类 号：R544.1[医药卫生—心血管疾病]