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目的 探讨高血压伴胰岛素抵抗颈动脉血流动力学及血管壁顺应性变化与动脉粥样硬化形成的关系。方法 选择原发性高血压 (EH)病人 48例 ,正常对照 49人。按胰岛素抵抗指数 (HOMA)分 3组 ,原发性高血压伴胰岛素抵抗[EHIR( +) ]组 ,原发性高血压无胰岛素抵抗 [EHIR( -) ]组 ,正常对照组 (NEH)。应用二维彩色超声诊断仪测定受检者颈动脉参数及临床生化指标 ,计算HOMA指数、CSDC、Vd Vs评估胰岛素抵抗颈动脉血流动力学及血管壁顺应性。结果 EHIR( +)组HOMA指数与IMT呈正相关 (r =0 3 8,P <0 0 1) ,CSDC与HOMA指数呈负相关 (r =-0 2 9,P <0 0 1) ,Vd Vs与HOMA指数呈负相关 (r =-0 3 1,P <0 0 1)。BMI、甘油三酯 (TG)水平高于EHIR( -)及NEH组 (P <0 0 5 )。高密度脂蛋白 (HDL C)水平及颈动脉斑块大小在EHIR( +)组明显低于EHIR( -)组 (P <0 .0 5 )。结论 高血压伴胰岛素抵抗病人颈动脉血流动力学及血管壁顺应性变化与动脉粥样硬化形成相关
Objective To investigate the relationship between the changes of carotid hemodynamics and vessel wall compliance and the formation of atherosclerosis in patients with hypertension and insulin resistance. Methods 48 cases of essential hypertension (EH) patients, 49 normal controls. The patients were divided into three groups according to the insulin resistance index (HOMA), essential hypertension with insulin resistance [EHIR (+)] group, essential hypertension without insulin resistance [EHIR (-)] group and normal control group (NEH). The carotid artery parameters and clinical biochemical parameters were measured by two-dimensional color ultrasonic diagnostic apparatus. The HOMA index, CSDC and Vd Vs were calculated to evaluate the carotid hemodynamics and vessel wall compliance of insulin resistance. Results There was a positive correlation between HOMA index and IMT in EHIR (+) group (r = 0 3 8, P 0 01) and CSDC was negatively correlated with HOMA index (r 0 02 9, P 0 01) Negatively correlated with HOMA index (r = -031, P <0.01). BMI and triglyceride (TG) levels were higher than those in EHIR (-) and NEH groups (P <0.05). High-density lipoprotein (HDL C) levels and carotid plaque size were significantly lower in the EHIR (+) group than in the EHIR (-) group (P <0.05). Conclusion The changes of carotid hemodynamics and vascular wall compliance in patients with hypertension and insulin resistance are related to the formation of atherosclerosis