原发性高血压及脑卒中红细胞Na^+/Mg^(2+)交换率与胰岛素抵抗和类洋地黄相关性研究  

Correlation Between Erythrocyte Na^+/Mg^( 2+) Exchange Rate and Insulin Resistance Versus Endogenous Digitalis-Like Substances in Patients With Essential Hypertension or Stroke

作　　者：袁林 李培[2] 苗蓁蓁 赵萍 朱成章 周兢业[5] 尹祚莹[5] 

机构地区：[1]贵阳市第二人民医院心内科,贵州省550002 [2]贵阳医学院老年病研究所 [3]贵阳市第二人民医院检验科,贵州省550002 [4]贵阳市第二人民医院神经内科,贵州省550002 [5]中国科学院地球化学研究所

出　　处：《中国循环杂志》2002年第2期105-108,共4页Chinese Circulation Journal

基　　金：贵阳市自然科技基金资助 (1 998 1 4 0 8)

摘　　要：目的 :探讨原发性高血压、脑出血和脑梗塞急、慢性期血浆Na+ 、Mg2 + 及红细胞内Na+ 、Mg2 + 含量和Na+ /Mg2 + 交换率 ,以及与胰岛素抵抗和类洋地黄物质相关性。方法 :随机选择 78例患者分为原发性高血压组 (n =2 3)、脑出血组 (n =2 1)和脑梗塞组 (n =34) ,并选 2 0例健康查体者为对照组。采用原子吸收光谱火焰法测原发性高血压、脑出血、脑梗塞患者红细胞内Na+ 、Mg2 + 含量和Na+ /Mg2 +交换率〔钠 -镁外流最大速率 (VTmax)、非钠依赖性镁外流最大速率 (VNimax)、钠依赖性镁外流最大速率 (VNdmax)〕。同时测空腹血糖、血浆胰岛素和类洋地黄物质浓度。结果 :原发性高血压组血浆Na+ 、Mg2 + 与对照组相比无明显统计学差异 ,而原发性高血压组、脑出血组和脑梗塞组急、慢性期红细胞内Mg2 + 含量明显降低 ,VTmax、VNdmax明显增高 ,有显著性差异 (P均 <0 0 5 ) ,脑出血组、脑梗塞组急、慢性期红细胞内Na+ 含量则明显增高 (P <0 0 5～ 0 0 0 1) ,有显著性差异 ,红细胞内Mg2 + 含量、VNdmax与胰岛素抵抗和类洋地黄物质呈明显负相关 ,而红细胞内Na+ 含量与胰岛素抵抗和类洋地黄物质呈明显正相关。结论 :从以上结果可以看出原发性高血压和脑卒中患者由于红细胞内外Na+ /Mg2 + 转换率加快 。Objective:To investigate the correlation between levels of plasma natrium(PNa),magnesium (PMg),erythrocyte natrium(ENC),magnesium (EMC),erthrocyte Na +/Mg 2+ exchange rate and endogenous digitalis-like substances (EDLS) versus insulin resistance (ISI)in patients with essential hypertension(EH),complicated by acute and chronic cerebral hemorrhage (CH) or cerebral infarction (CI). Methods:PNa,PMg,ENC,EMC and Na +/Mg 2+ exchange rate [maximum rates of total magnesium efflux (VTmax),sodium-independent magnesium efflux (VNImax),sodium-dependent magnesium efflux (VNdmax)] were measured by flame assay of atomic absorption spectropholometry.Plasma EDLS,fasting insulin and blood sugar were also determined. Results:PNa,PMg in EH group were not significantly different from those of the normal controls (p<0.05).EMC in EH,CH,CI was significantly reduced (p<0.05-0.001)and ENC was significantly elevated(p<0.01-0.001).VTmax and VNdmax in EH,CH,CI were higher than those of the controls (p<0.05-0.01).EMC and VNdmax were significantly negatively correlated with EDLS and ISI.ENC was significantly positively correlated with EDLS and ISI. Conclusion:The elevated erythrocyte Na +/Mg 2+ exchange rate in EH and stroke may be responsible for the decreased EMC and increased ENC.Also,ISI and EDLS may be involoed in and regnlated the process.

关 键 词：原发性高血压 脑卒中 红细胞 胰岛素抵抗 类洋地黄 离子交换 钠离子 镁离子 

分 类 号：R544.1[医药卫生—心血管疾病] R743.3[医药卫生—内科学]