原发性高血压胰岛素抵抗与心率变异性的关系及临床干预治疗  

Relationship between Insulin Resistance and Heart Rate Variability in Patients with Hypertension and Clinical Interventional Treatment

作　　者：赵玉杰[1] 周聊生[1] 娄兹谟[1] 邢启崇[1] 李建[1] 刘建华[1] 王清[1] 李莹[1] 玄军[1] 刘志福[1] 

机构地区：[1]山东省千佛山医院心内科,山东省济南市250014

出　　处：《中国循环杂志》2001年第2期103-105,共3页Chinese Circulation Journal

摘　　要：目的：探讨原发性高血压伴胰岛素抵抗与心率变异性的关系及临床干预后的变化。 方法：原发性高血压胰岛素抵抗患者６０例为胰岛素抵抗组，非胰岛素抵抗患者３０例为非胰岛素抵抗组，正常对照３０例为正常对照组，行心率变异比较后将胰岛素抵抗组患者随机分成胰岛素抵抗Ａ、Ｂ ２组各 ３０例，胰岛素抵抗Ａ组给予钙离子拮抗剂，胰岛素抵抗Ｂ组给予血管紧张素转换酶抑制剂分别治疗４周。 结果：药物治疗前胰岛素抵抗组与非胰岛素抵抗组和正常对照组心率变异各项指标比较有显著性差异（Ｐ＜０．０１）。治疗后胰岛素抵抗Ａ组胰岛素水平及心率变异指标改善不显著；胰岛素抵抗Ｂ组胰岛素水平及心率变异指标明显改善，２组间比较有显著性差异（Ｐ＜０．０１）。 结论：血管紧张素转换酶抑制剂贝那普利较好地改善了血胰岛素水平及心率变异各项指标，其效果优于钙离子拮抗剂硝苯地平。Objective:To evaluate the relationship between insulin resistance and heart rate variability (HRV)in patients with hypertension. Methods: We studied 60 patients with hypertension accompanied by insulin resistance and 30 patients without insulin resistance. Thirty normal subjects served as controls. Sixty patients with hypertension accompanied by insulin resistance were randomized into two groups. Calcium channel blocker(CCB,group A,n=30) and angiotensin converting enzyme inhibitor (ACEI,group B,n=30)were administered for 4 weeks respectively. Results :Before treatment the parameters of HRV in hypertensive patients with insulin resistance were significant different (p<0. 01,respectively)compared with those in the patients without insulin resistance and normal subjects. The level of insulin and parameters of HRV were not improved significanty in group A after administration of CCB, but significant in group B(P<0.01). The differences between groups A and B were significant (p<0. 01). Conclusion: ACEI agent can improve the level of blood insulin and the parameters of HRV. It is very different compared with CCB agent.

关 键 词：胰岛素抵抗 心率变异性 原发性高血压 干预治疗 

分 类 号：R544.1[医药卫生—心血管疾病]