老年高血压代谢综合征和糖尿病患者胰岛素抵抗与心血管内分泌激素关系的研究  

Study on relations between insulin resistance and cardiovascular endocrinic hormones in elderly patients with essential hypertension metabolic syndrome and NIDDM

作　　者：王爱玲[1] 王子先[1] 尹长森[1] 刘本堂[1] 汤涛[1] 

机构地区：[1]安徽省立医院心内科,合肥230001

出　　处：《临床心血管病杂志》2001年第1期11-13,共3页Journal of Clinical Cardiology

基　　金：安徽省科委课题!(No.19942 10 - 44 )

摘　　要：目的 :研究老年原发性高血压 (EH)、代谢综合征 (MS)和 2型糖尿病 (NIDDM)患者的胰岛素敏感性 (ISI)及与心血管内分泌激素 (CEH)的关系 ,分析胰岛素抵抗 (IR)与 CEH在 EH和 NIDDM的发病中的作用和机制。方法 :随机抽取 1 994～ 1 998年期间的住院老年患者 (≥ 60岁 )1 88例 ,分为 EH组 70例 ,NIDDM33例 ,MS组 39例 ,健康组 46例 ,测血浆心钠素 (ANP)、内皮素 (ET)、血管紧张素 和 (A 和 A )、儿茶酚胺 (CA)、血胰岛素 (INs)、血糖和血脂等。用 SAS软件分析。结果 :EH、NIDDM、MS组与健康人比较均存在 IR。在 3个病患组中 ,均有 ET、CA、肾上腺素和去甲肾上腺素的显著升高。在 EH和 MS组中 ,A 和 A 均升高。 EH患者胰岛素敏感指数下降的发生率为 70 %。在 EH和 MS组中 ,均发现肥胖者较非肥胖者 IR程度严重。结论 :IR的影响因素多。 CEH和代谢紊乱与 IR关系密切 ,CEH紊乱和 IR互相影响 ,在 EH和 MS发病中可能有协同作用。这可能是老年 EH和 NIDDM常并存的原因之一。Objective:To research on the relations of insulin resistance(IR)and cardiovascular endocrinic hormones(CEH)in elderly essential hypertension(EH),metabolic syndrome(MS)and NIDDM,and to explore the important risk factors and the relations in pathology of EH,MS and NIDDM.Method:Randomly enrolled 188 subjects (≥60 age) seen at hospital in 1994～1998,including 70 EH,33 NIDDM,39 MS and 46 normal controls, were studied about insulin sensitive index [ISI, Ln(BG×INs)],ANP,ET,CA,AⅠ and AⅡ et al.SAS statistical software was used to analyse the differences and relations about each group′s results.Result:Compared with control group, EH,NIDDM and MS groups had lower ISI and higher levels of ET and CA.In addition,EH and MS had increased AⅠ and AⅡ ( P< 0.05 ).The ratio of ISI was 70% in EH group.Furthermore,fat patients in EH and MS groups had more severe IR.The factors which might affect IR in each group were also analysed.Conclusion:IR was affected with many factors.Cardiovascular endocrinic hormones were closely related with IR.There was coordinated effect between IR and cardiovascular endocrinic hormones in pathogenesis of EH and MS,this might be one of the major mechanisms causing elderly EH and NIDDM.

关 键 词：胰岛素抵抗 高血压 代谢综合征 Ⅱ型糖尿病 心血管内分泌激素 

分 类 号：R544.106[医药卫生—心血管疾病] R587.02[医药卫生—内科学]