高血压患者认知功能损害与血清瘦素水平及胰岛素抵抗的关系  

Relationship of cognitive function impairment with serum leptin level and insulin resistance in hypertensive patients

作　　者：彭清[1] 王小洁[2] 卢建刚[1] 陈梅[3] 徐勇[2] 

机构地区：[1]四川泸州医学院附属医院心内科,四川泸州646000 [2]四川泸州医学院附属医院内分泌科 [3]四川泸州医学院附属医院血液科

出　　处：《临床心血管病杂志》2012年第8期574-577,共4页Journal of Clinical Cardiology

基　　金：泸州医学院学院课题资助(No:200932)

摘　　要：目的:探讨高血压患者认知功能损害与血清瘦素水平及胰岛素抵抗的关系。方法:根据国际通用的简易智力状况检查表,对200例高血压患者的认知功能进行评分。根据评分结果,将所有患者分为认知功能障碍组(病例组)44例和认知功能正常组(对照组)156例。按统一方法测量所有患者的血压、身高、体重等,收集空腹静脉血,测定血脂、血糖、胰岛素和瘦素等。用胰岛素抵抗指数(IRI)作为胰岛素敏感性评价指标。结果:2组患者的文化程度、饮酒史、脑血管病史、年龄、舒张压、胰岛素、IRI及瘦素比较均差异有统计学意义(均P<0.05)。年龄、文化程度、脑血管病史、IRI及瘦素与认知功能呈正相关(OR值分别为1.097、7.141、4.012、1.108、2.303,均P<0.05)。结论:高血压患者认知功能损害除与文化程度、年龄及脑血管病史相关外,还与瘦素及胰岛素抵抗密切相关。瘦素、胰岛素抵抗是高血压患者认知功能障碍重要的危险因素。Objective：To explore the relationship of cognitive function impairment with serum leptin level and insulin resistance in hypertensive patients.Method：Two hundred hypertensive patients were divided into two groups according to the mini mental state examination scores： patients with impaired cognition were classified as case group（n=44）,and patients with normal cognition were classified as control group（n=156）.The basic information such as blood pressure,height and body weight were recorded.TC,TG,fasting plasma glucose,fasting plasma insulin and serum leptin level were measured.Insulin resistance index（IRI） was calculated to estimate the insulin resistance.Result：There were significant differences in age,educational level,diastolic pressure,history of alcohol drinking and cerebrovascular disease,insulin,IRI and serum leptin between the two groups（P〈0.05）.Age,educational level,history of cerebrovascular disease,IRI and serum leptin（OR=1.097,7.141,4.012,1.108,2.303,P〈0.05） were positively correlated to cognitive impairment.Conclusion：Besides educational level,age and history of cerebrovascular disease,IRI and leptin are associated with cognitive function impairment.IRI and leptin may be independent risk factors of cognitive deterioration in primary hypertensive patients.

关 键 词：高血压 认知功能 瘦素 胰岛素抵抗 

分 类 号：R544.1[医药卫生—心血管疾病]