【摘要】 目的观察老年高血压患者颈动脉粥样硬化的特点,探讨胰岛素抵抗与老年高血压病动脉粥样硬化的相关性。方法单纯高血压组(EH)组98例,高血压合并糖尿病组(EH+DM组)103例,健康对照组92例,均行超声检查颈动脉内膜中层厚度(IMT),测定空腹血糖和胰岛素、动态血压、甘油三酯、胆固醇、高密度脂蛋白、BMI,计算稳态模式评估法的胰岛素抵抗指数(HOMA-IR),并与心血管危险因素做相关分析。结果IMT与HOMA-IR、BMI和空腹血糖呈正相关;IMT、FBG、血脂、BMI等指标,EH+DM组显著高于EH组(P<0.05),EH组高于对照组(P<0.05)。结论老年高血压合并糖尿病患者IMT显著增高,糖尿病合并高血压可加速动脉粥样硬化的进展,而且与高血压患者胰岛素抵抗的发生、发展密切相关。更多还原

【Abstract】 Objective To observe the characteristics in elderly hypertensive patients with carotid atherosclerosis,and the relationship between insulin resistance in elderly patients with hypertension and atherosclerosis.Methods 293 patients were divided into 3 groups:simple hypertension(EH)group with 98 cases;hypertension with diabetes mellitus(EH & DM)group was 103 cases;and the control group which was 92 cases of normal blood pressure.All patients underwent carotid ultrasound intima-media thickness(IMT)test.Determination of fasting blood glucose and insulin,ambulatory blood pressure,triglycerides,cholesterol,high density lipoprotein,BMI,calculated homeostasis model assessment of insulin resistance index(HOMA-IR),and correlation analysis of cardiovascular risk factors.Results Carotid artery IMT was positively correlated to HOMA-IR,BMI and fasting blood glucose;Carotid artery IMT,FBG,lipids,BMI were significantly higher in EH & DM group than that in EH group(P<0.05);and those were also significantly higher in EH group than in control group(P<0.05).Conclusion IMT was significantly higher in the elderly with hypertensive and diabetes mellitus,DM and EH can be accelerated with the development of carotid atherosclerosis,and are closely related to insulin resistance and hypertension development.更多还原