【摘要】 目的　探讨高血压病胰岛素抵抗 (IR)与微循环障碍的关系。方法　测定 42例高血压病患者血糖、胰岛素等生化指标 ,以评价胰岛素敏感性。观测了大动脉、小动脉、毛细血管压、毛细血管密度、口径、全血粘度、血浆粘度、一氧化氮 (NO)及反应性充血过程中血流和血氧等指标。通过多元回归分析 ,探讨了高血压病胰岛素抵抗的可能机理。结果　高血压病患者体重指数增加 ,肥胖、高脂血症、高胰岛素血症增多 ;微循环储备功能减退 ;糖耐量降低、IR ;大动脉、小动脉、毛细血管压升高 (P <0 .0 5 ) ;毛细血管密度、口径变小 ,全血、血浆粘度、ET、TXB2 升高 ,PGI2 、NO降低 (P <0 .0 5 )。且胰岛素敏感性与毛细血管密度、NO呈正相关 ,与血浆粘度呈负相关 (P <0 .0 5 )。结论　高血压患者存在IR、高胰岛素血症及微循环储备功能减退 ,可能与微循环障碍、内皮功能紊乱 ,尤其是毛细血管数目、NO减少 ,血浆粘度升高有关。更多还原

【Abstract】 Objective To study the relationshop between insulin resistance(IR) and microcirculatory disturbance in patients with essential hypertension(EH). Method 42 patients with EH were included in the study and thirty six healthy subjects were used as control. Serum glucose(G)、 insulin(Ins)、 insulin sensitive index(ISI) were determined. Arterial(BP)、Arteriolar(ZB)、Capillary blood pressure(CBP)、Capillary loop density(DD)、diameter(DM)、blood viscosity(η b)、plasma viscosity(η b)、NO and LDF、PtCO 2 of the PORH were also measured. Results Compared with control group, Ins、BP、zBP、cBP、η b、η p were significantly higher(P<0.05～0.01), G/Ins、G-AUC/I-AUC、ISI、DD、DM were the hypermia peak flow(PF)、PF/RF(the rest flow) increase(P<0.05), the LDF and PtCO 2 recovery time of PORH at carpus was significantly lower(P<0.05). Conclusion There were impaired glucose tolerance and microcirculation reserve, hyperinslinemia, insulin resistance in EH, It is possible mechanisms that Capillary loop density NO decreases, plasma viscosity increases in EH.更多还原