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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 investigate the relationship between insulin sensitivity (ISI) and cardiovascular endocrine hormone (CEH) in senile patients with essential hypertension (EH), metabolic syndrome (MS) and type 2 diabetes mellitus IR) and CEH in the pathogenesis of EH and NIDDM. Methods: A total of 1 88 hospitalized elderly patients (≥60 years) were enrolled in this study. They were randomly divided into EH group (70 cases), NIDDM group (33 cases), MS group (39 cases) and healthy group (46 cases). Plasma atrial natriuretic peptide ANP), endothelin (ET), angiotensin (A and A), catecholamine (CA), insulin (INs), blood glucose and blood lipids. SAS software analysis. Results: EH, NIDDM, MS group compared with healthy people have IR. In all three patient groups there was a significant increase in ET, CA, epinephrine and norepinephrine. In EH and MS groups, both A and A increased. EH patients with insulin sensitivity index decreased incidence of 70%. In both the EH and MS groups, obesity was found to be more severe than non-obese IR. Conclusion: There are many influencing factors of IR. CEH and metabolic disorders are closely related to IR, CEH disorders and IR affect each other, and there may be synergistic effects in the pathogenesis of EH and MS. This may be one of the reasons why elderly EH and NIDDM coexist.