调节血糖代谢对盐敏感性高血压患者盐敏感性的影响  

Influence of regulation of blood glucose metabolism on salt sensitivity in patients with salt-sensitive hypertension

作　　者：高峰[1] 周静[1] 万招飞[1] 刘哲[1] 高智耀[1] 白怀生[1] 刘兆英[1] 

机构地区：[1]延安大学附属医院心血管内科一病区,陕西延安716000

出　　处：《心血管康复医学杂志》2012年第3期270-272,共3页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:观察调节血糖代谢对盐敏感性高血压患者盐敏感性的影响。方法:对190例高血压患者进行急性盐水负荷试验,确定盐敏感性高血压(SSH)125例,非盐敏感性高血压(NSSH)65例,分别进行糖耐量试验及胰岛素同步释放试验。试验后所有高血压患者被随机分为两组:二甲双胍组(100例,予以二甲双胍口服,有SSH 65例,NSSH 35例),安慰剂对照组(90例,有SSH 60例,NSSH 30例),3个月后再次行盐敏感性试验、糖耐量试验及胰岛素同步释放试验。结果:1、两组的NSS患者治疗前后胰岛素、血压均无显著差异,P>0.05;2、二甲双胍组治疗后:(1)SSH患者盐敏感性显著降低,有24例(19.2%)患者转为NSSH;(2)SSH患者平均动脉压较NSSH者明显下降[(104.05±9.30)mmHg比(119.21±13.73)mmHg,P<0.05],且较安慰剂对照组SSH者明显下降[(104.05±9.30)mmHg比(116.87±10.05)mmHg P<0.05];(3)SSH患者较治疗前,空腹血胰岛素(FINS)水平[(27.7±20.9)μIU/ml比(9.7±2.5)μIU/ml]显著降低,空腹胰岛素敏感指数(ISI)[(0.0106±0.0090)比(0.0280±0.0086)]显著上升(P均<0.05),且显著优于安慰剂对照组SSH患者治疗后[空腹FINS(9.7±2.5)μIU/ml比(27.7±20.5)μIU/ml,空腹ISI(0.0280±0.0086)比(0.0110±0.0086)]。结论:改善血糖代谢及胰岛素敏感性能降低盐敏感高血压患者的盐敏感性及改善血压控制。Objective： To investigate influence of regulation of blood glucose metabolism on salt sensitivity in patients with salt-sensitive hypertension （SSH）. Methods： After acute saline load test, a total of 125 cases with SSH and 65 cases with non-SS hypertension （NSSH） were determined from 190 patients with hypertension, and then they underwent glucose tolerance test and insulin synchronous release test. After that, all patients were randomly divided into metformin group （n= 100, received metformin, including 65 SSH cases and 35 NSSH cases） and placebo control group （n = 90, including 60 SSH cases and 30 NSSH cases）. Salt sensitivity test, glucose tolerance test and insulin synchronous release test were performed in all patients after three months. Results： 1, Insulin, blood pressure didn＂ t significant change before and after treatment in NSSH patients of two groups, P〉0.05 ; 2, After treatment in metformin group, salt sensitivity of SSH patients significantly decreased and 24 （19.2%） patients turn into NSSH; （2） mean arterial pressure of SSH patients significantly decreased compared with that of NSSH patients [ （104.05 ± 9.30） mmHg vs. （119.21 ± 13.73） mmHg, P〈0.05], and were lower than those of SSH patients of placebo control group [ （104. 05 ± 9.30） mmHg vs. （116.87 ± 10.05） mmHg, P〈0.05] ; （3） Compared with before treatment, fasting blood insulin （FINS） [ （27.7 ± 20.9） uIU/ml vs. （9.7 ± 2.5） uIU/ml], insulin sensitivity index （ISI） significantly increased [ （0. 0106 ± 0. 0090） vs. （0. 0280 ± 0. 0086）] （P〈0.05 all） in SSH patients, and significantly improved than those of SSH patients of placebo control group [FINS （9.7 ± 2.5） uIU/ml vs. （27.7 ± 20.5） uIU/ml, fasting ISI （0. 0280 ±0. 0086） vs. （0. 0110 ± 0. 0086）]. Conclusion： Improvement of blood glucose metabolism and insulin sensitivity can reduce salt sensitivity and improve control of blood pressure in patients with salt-sensitive hypertensio

关 键 词：血糖 胰岛素 高血压 

分 类 号：R544.1[医药卫生—心血管疾病]