[目的]探讨高血压患者胰岛素抵抗与代谢综合征、心血管事件的相关性.[方法]回顾性分析2015年4月至2016年8月本院收治的191例高血压患者的临床资料,根据是否存在胰岛素抵抗将其分为单纯高血压组(对照组,n =106)和高血压伴胰岛素抵抗组(观察组,n =85).根据国际糖尿病联盟代谢综合征的相关定义将患者分为代谢综合征组(n=101)和非代谢综合征组(n =90).记录各组患者SBP、DBP、身高、体质量并计算其体质量指数(BM I),检测两组受试者总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、血尿素氮(BUN)、肌酐(SCr)、空腹血糖(FPG)、心肌标志物,采用酶联免疫法测定空腹胰岛素(FINS)、脂联素(APN)、高敏C反应蛋白(hs-CRP)水平.对所有患者进行为期1年随访,记录患者心血管事件发生情况.[结果]观察组血清FPG、FINS、APN、hs-CRP、HOMA-IR水平与对照组比较,差异具有统计学意义(P <0.05).由表中数据可知代谢综合征组患者SBP、DBP、FPG、APN、BUN、hs-CRP、HOMA-IR水平明显高于非代谢综合征组,HDL-C水平明显低于非代谢综合征组,差异具有统计学意义(P <0.05).HDL-C、BUN、hs-CRP、HOMA-IR为代谢综合征独立危险因素(P <0.05).所有患者随访1年,对照组患者发生心血管事件36例,观察组72例.进一步采用多因素Logistic回归分析显示,血清 HDL-C、TG、hs-CRP、HOMA-IR水平为高血压患者发生心血管事件的危险因素(P <0.05).[结论]高血压伴胰岛素抵抗患者其胰岛素抵抗程度高于单纯高血压患者;胰岛素抵抗与代谢综合征显著相关,为高血压患者发生心血管事件的危险因素.“,”[Objective]To investigate the relationships of insulin resistance with metabolic syndrome and with cardiovascu-lar events in patients with hypertension.[Methods]A total of 191 patients with hypertension in our hospital from April 2015 to August 2016 were selected as study subjects.According to the insulin resistance index,patients were divided into the simple hypertension group(the control group)and insulin-resistant hypertension group(the observation group).The systolic blood pressure,diastolic blood pressure,glucose and lipid metabolism,high sensitivity C reactive protein,and adiponectin were de-tected for all patients and insulin resistance indexes were calculated.The incidence of cardiovascular events were recorded through one year of follow-ups.[Results](1)There were statistically significant differences in blood pressure,glucose metab-olism,lipid metabolism,high sensitivity C reactive protein,adiponectin,and insulin resistance indices of the two groups(P<0.05);(2)In the control group,patients with metabolic syndrome had significantly higher levels of fasting glucose and adi-ponectin levels than those with non-metabolic syndrome.The fasting blood glucose,adiponectin,high-sensitivity C-reactive protein and insulin resistance index of metabolic syndrome patients in the observation group were significantly higher than those in non-metabolic syndrome patients,and the levels of high-density lipoprotein cholesterol were significantly lower than those in metabolic syndrome patients(P <0.05).(3)With regards to the relationship between metabolic syndrome and metabolic risk factors;the high density lipoprotein cholesterol was negatively correlated with metabolic syndrome.Uric acid,high-sensitivity C reactive protein and insulin resistance index were positively correlated with metabolic syndrome.(4)A 1-year follow-up of patients with hypertension showed that high insulin resistance index,high triglyceride,high sensitive C reactive protein and low high density lipoprotein cholesterol had a higher probability of cardiovascular events(P <0.05).[Conclusion] Insulin re-sistance is significantly higher in hypertensive patients than in normal subjects.Insulin resistance is significantly associated with metabolic syndrome;insulin resistance index potentially becomes a new predictor after traditional cardiovascular risk factors such as high-density lipoprotein cholesterol,triacylglycerol,and high-sensitivity C-reactive protein.