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目的探讨原发性高血压(EH)患者不同程度颈动脉粥样硬化(CAS)内膜中层厚度(IMT)与胰岛素抵抗(IR)及脂联素(APN)的关系,观察IR指数值与血清APN水平二者的相关性。方法应用彩色多普勒超声检查将171例EH患者按颈动脉硬化程度分为颈动脉正常组、颈动脉内膜增厚组和颈动脉斑块形成组,分别测定各组IR指数值及血清APN的水平,观察CASIMT与IR指数值及血清APN水平的关系。结果 EH伴CAS患者130例占76.02%(130/171)。EH患者IR指数值显著高于健康对照组(P<0.05),血清APN水平显著低于健康对照组(P<0.05);颈动脉斑块形成组及颈动脉内膜增厚组与颈动脉内膜正常组比较,IR指数值均显著增高(P<0.05),血清APN水平均显著降低(P<0.05);颈动脉内膜正常组与健康对照组比较,IR指数值显著增高(P<0.05),血清APN水平显著降低(P<0.05)。EH伴CAS患者IR指数值与外周血APN水平呈显著性负相关(r=-0.357,P<0.05)。结论 EH患者体内存在IR及APN水平的异常表达,其可能参与了EH伴CAS发生发展的过程,此为早期干预EH发生AS提供了理论依据,IR指数及血清APN可作为EH的辅助诊断及治疗的指标之一。
Objective To investigate the relationship between carotid atherosclerosis (CAS) intima - media thickness (IMT) and insulin resistance (IR) and adiponectin (APN) in patients with essential hypertension (EH) APN level of the correlation between the two. Methods 171 patients with EH were divided into carotid artery normal group, carotid artery intimal thickening group and carotid artery plaque formation group according to the degree of carotid atherosclerosis by color Doppler ultrasonography. The IR index and serum APN The relationship between CASIMT and IR index and serum APN levels was observed. Results 130 cases of EH with CAS accounted for 76.02% (130/171). The index of IR of EH patients was significantly higher than that of healthy controls (P <0.05), while the level of serum APN was significantly lower than that of healthy controls (P <0.05). Carotid artery plaque formation and carotid intima-media thickness Compared with normal control group, IR index increased significantly (P <0.05) and serum APN level decreased significantly (P <0.05); IR index increased significantly in normal carotid intima-media group compared with healthy control group (P <0.05) ), Serum APN levels were significantly lower (P <0.05). There was a significant negative correlation between the IR index of EH with CAS and APN level of peripheral blood (r = -0.357, P <0.05). Conclusions The abnormal expression of IR and APN in EH patients may be involved in the process of EH with CAS. This provides a theoretical basis for the early intervention of EH in AS. The IR index and serum APN can be used as auxiliary diagnosis and treatment of EH One of the indicators.