【摘要】 目的　研究高血压病 (EH)患者胰岛素抵抗 (IR)与纤溶系统的关系。方法　EH病人 71例 ,采用 75g葡萄糖口服负荷法 (OGTT) ,将EH患者分为糖耐量正常组 (NGT) 44例和糖耐量异常组 (IGT) 2 7例 ,正常对照组 3 1例。测定血浆组织型纤溶酶原激活物活性 (t PA)、纤溶酶原激活物抑制物 -1活性 (PAI 1)、纤溶酶原活性 (PLG) ,在OGTT测定的同时作血胰岛素 (INS)测定 ,并根据Cederholm公式计算出胰岛素敏感指数 (ISIc)。结果　NGT组和IGI组相比t PA无明显差别 (P >0 0 5) ,但两组均较正常对照组降低 (P <0 0 5)。NGT组和IGT组PAI -1与正常对照组比较均无明显差别 (P >0 0 5)。IGT与NGT相比PLG增高 (P <0 0 5) ,与正常对照比较PLG明显增高 (P <0 0 1)。ISIc在NGT组和IGT组较正常对照组明显降低 (P <0 0 5,P <0 0 1) ,且IGT组较NGT组更低 (P <0 0 1)。ISIc与t PA ,PAI 1不相关。结论　高血压病人存在胰岛素抵抗 ,当高血压病合并IGT时 ,胰岛素抵抗更明显。EH病人存在纤溶活性的下降 ,当合并IGT时 ,纤溶活性的降低更为明显。t PA和PAI 1与ISIc无明显相关性更多还原

【Abstract】 Objective To investigate the relationship between insulin resistance(IR) and fibrinolysis in patients of hypertension. Methods Plasma plasminogen activator inhibitor type 1(PAI 1), tissue type plasminogen(t PA), plasminogen(PLG) activities were measured.\ Oral glucose tolerance test(OGTT), insulin release test(IRT) were performed. Insulin resistance was determined by insulin sensitive index(ISIc). Three groups of subjects were categorized as followings: Forty four hypertensive patients with normal glucose tolerance(NGT), 27 with impaired glucose tolerance(IGT) and thirty one healthy subjects as control. Results t PA activities were not different between patients with NGT and IGT, while they are significantly decreased compared to the controls( P <0 05). No differences were found in PAI 1 among the hypertensive patients with IGT, NGT and the healthy control. Plasma PLG was significantly greater in patients with IGT than that in patients of NGT and the controls. ISIc was decreased markedly in both IGT and NGT groups while the most significant changes found in patients of IGT. No correlation was showm between t PA, PAI 1 and ISIc. Conclusion Patients with hypertension had decreased fibrinolysis activities. The most remarkable changes were found in the hypertensive patients with impaired glucose tolerance. No correlation beween insulin sensitive index and activities of t PA and PAI 1 were found.更多还原