高血压病患者血浆胰岛素原和真胰岛素水平及雷米普利干预的影响

目的 探讨高血压病患者血浆胰岛素原（PI）及真胰岛素（TI）水平及与血压的相关性和雷米普利的影响。方法 用酶联免疫吸附法检测24例健康人及44例高血压病患者血浆PI、TI,用放免法测定血浆免疫反应性胰岛素（IRI）水平;观察21例高血压病患者经雷米普利治疗前后上述指标的变化。结果 高血压病组患者与对照组比较PI、PI／TI和IRI浓度,差异有显著性（P值均＜0．01）,而TI差异无统计学意义（P＞0．05）;PI与TI呈正相关,PI与收缩压与舒张压无明显相关性;21例高血压病患者用雷米普利治疗后PI、PI／TI和IRI水平有明显下降（P＜值均＜0．05）;胰岛素敏感性差异有显著性（P＜0．01）,TI水平差异则无统计学意义（P＞0．05）。结论 高血压病患者血浆PI浓度增高,存在胰岛β细胞功能障碍;雷米普利可降低血浆PI水平,可能与胰岛β细胞的功能改善有关。

The plasma levels of proinsulin and true insulin and the effects of ramipril in hypertension

OBJECTIVE: To explore the dynamic changes of plasma proinsulin (PI) and true insulin (TI) and their relation with essential hypertension (EH) as well as to evaluate the therapeutic effect of ramipril. METHODS: PI, TI and immunoreactive insulin (IRI) were measured in 44 cases of EH, 24 normal subjects and 21 cases of EH before and after treatment with ramipril. RESULTS: The mean plasma level of PI and IRI in EH was significantly higher than that in the control group (P < 0.01); there was no significant difference in the level of TI (P > 0.05). PI was positively related to TI, There was no significant relation between PI with SBP and DBP. Plasma concentration of IRI and PI (P < 0.05), decreased remarkably, but the level of TI remained unchanged after therapy with ramipril (n = 21). CONCLUSION: The plasma concentration of PI is elevated in patients with EH due probably to impaired function of beta-cells of the pancreatic islets. Ramipril can decrease the level of PI and improve pancreatic beta cell function.