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目的探讨醛固酮水平与原发性高血压(EH)患者胰岛素抵抗、左室重构及葡萄糖代谢异常的相关性。方法收集2006-06-2007-12资料完整连续住院的160例EH患者,根据HOMA-IR公式计算的胰岛素抵抗指数将其分为:胰岛素抵抗(IR)组、非胰岛素抵抗(N-IR)组;并比较两组间年龄、体质量指数、醛固酮、血钾、血钠、三酰甘油、总胆固醇、血肌酐清除率、左室射血分数、左室质量指数及葡萄糖代谢情况。结果IR组的醛固酮水平[IR组(117.4±43.4)比N-IR组(103.2±40.2)ng/L,P<0.05]、左室质量指数[IR组(155.7±51.2)比N-IR组(141.2±35.7)g/m2,P<0.05]高于N-IR组;IR组患者发生葡萄糖代谢异常的比例(78.9%)与N-IR组(44.6%)患者差异有统计学意义(P<0.05)。结论高醛固酮水平与EH患者胰岛素抵抗有关,并可能与其左室重构、葡萄糖代谢异常相关。
Objective To investigate the relationship between aldosterone level and insulin resistance, left ventricular remodeling and abnormal glucose metabolism in patients with essential hypertension (EH). Methods A total of 160 patients with EH admitted to our hospital from June 2006 to July 2007 were enrolled in this study. The insulin resistance index calculated by HOMA-IR formula was divided into three groups: insulin resistance (IR) group, non-insulin resistance (N-IR) ; And compared age, body mass index, aldosterone, serum potassium, serum sodium, triglyceride, total cholesterol, serum creatinine clearance, left ventricular ejection fraction, left ventricular mass index and glucose metabolism. Results The level of aldosterone in IR group was significantly higher than that in IR group (117.4 ± 43.4 vs 103.2 ± 40.2 ng / L, P <0.05), and LV mass index (155.7 ± 51.2) (141.2 ± 35.7) g / m2, P <0.05] higher than that in the N-IR group. There was a significant difference between the IR group and the N-IR group (78.9% vs 44.6% <0.05). Conclusions High aldosterone levels are associated with insulin resistance in EH patients and may be related to left ventricular remodeling and abnormal glucose metabolism.