65例肥胖高血压患者在不同胰岛素抵抗状况下血脂及超敏C-反应蛋白的变化

目的:了解肥胖高血压患者在不同胰岛素抵抗状况下血脂及HS-CRP的变化。方法:收集住院高血压患者97例,其中肥胖者65例。以所有病例胰岛素敏感性指数(ISI)中位数(ISI=0.14)为界,将肥胖高血压患者分为胰岛素抵抗组与非胰岛素抵抗组,比较两组间血脂及HS-CRP的变化。结果:肥胖高血压伴胰岛素抵抗组(IR)与非胰岛素抵抗组(NIR)相比,腹围(WC)和腰臀比(WHR)显著升高(P<0.05),HS-CRP亦明显升高(P<0.05)。两组间胆固醇(CHOL)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)比较差异无统计学意义(P>0.05)。肥胖高血压患者HS-CRP与胰岛素敏感性指数(ISI)呈负相关(R=-0.375,P<0.01),与腹围(WC)、腰臀比(WHR)、体质量指数(BMI)、胆固醇(CHOL)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)均无相关性(P>0.05)。结论:肥胖高血压患者伴胰岛素抵抗者,反应血管内皮炎性反应状态的敏感指标HS-CRP显著升高,提示其潜在心血管事件发生危险可能性更大。高血压患者治疗需针对心血管危险因素进行综合干预。

The Comparison of lipids and High Sensitivity C - reactive protein in Different State of insulin resistance in Obese Hypertensive Patients

Objective To observe the changes of lipids and high sensitivity C-reactive protein（ HS-CRP）in different state of insulin resistance in obese hypertensive patients. Method 97 hospitalized hypertensive patients were enrolled,and 65 of them were obesi-ty. According to the middle point of ISI of the total（ISI=0. 14）,the Obese Hypertensive Patients were divided into insulin resistance group （IR group）（ISI﹤0. 14）and non-insulin resistance group（NIR group）（ISI≥0. 14）. Then we compared HS-CRP,TG,HDL,CHOL,＆amp;nbsp;LDL between the IR group and NIR group by SPSS 16. 0. Results In the obese hypertensive patients,HS-CRP,WC and WHR were higher in the IR group than the NIR group（P﹤0. 05）. HS-CRP was only related to ISI in the obese hypertensive patients（R= -0. 375,P﹤0. 01）. Conclusion HS-CRP are higher in the obese hypertensive patients with insulin resistance. It suggests that the potential cardiovas-cular danger of the obese hypertensive patients with insulin resistance is higher and the comprehensive intervention is important to the treat-ment for hypertension.