老年高血压患者糖耐量减低与动脉粥样硬化关系研究

目的：观察高血压合并糖耐量减低患者颈动脉粥样硬化的特点,探讨糖耐量减低在老年高血压动脉粥样硬化的作用。方法：选取90例老年高血压患者按照葡萄糖耐量试验将研究对象按其是否合并糖耐量异常分为两组即单纯高血压组（41例）和高血压合并糖耐量异常组（49例）,同时做彩超测颈动脉内膜中层厚度（IMT）和斑块积分（PS）。根据公式计算出胰岛素抵抗指数（HOMA IR指数）,测量体重身高计算体重指数（BMI）,同时选取同龄30例正常血压者做为对照。结果：老年高血压合并糖耐量减低组的IMT、PS显著高于对照组差异有统计学意义（P〈0.01）,老年高血压合并糖耐量减低组高于单纯高血压组差异有统计学意义（P〈0.05）,高血压组高于对照组。结论：老年高血压合并糖耐量减低患者颈动脉粥样硬化程度显著高于单纯高血压组,胰岛素抵抗可能在动脉粥样硬化中起重要作用。

The Relationship between Impaired Glucose Tolerance and Carotid Artery Atherosclerosis in Elder Patients with Hypertension

Objective：To investigate the characteristics of carotid artery atherosclerosis（CAS）in patients with impaired glucose tolerance（IGT）and essential hypertension,and evaluate the role of IGT in the pathogenesis of atherosclerosis in elder patients with hypertension.Methods：A total of 90 patients were enrolled into this study ,According to glucose tolerance test,the essential hypertension with IGT group（Group B,n=41）,and the control group（Group C,n=36）.A color Doppler ultrasound was used to measure carotid intima-media thickness（IMT） and plaque score（PS）.The homeostasis model assessment insulin resistance index（HOMA-IR）was calculated based upon the levels of fasting plasma glucose（FSG）and fasting insulin（FSI）and the body mass index（BMI）was calculated based upon height and weight,An age-matched group of 30 patients with normal blood pressure as the controls.Results： The IMT and PS were higher in the essential hypertension with IGT group than those in the control group（P0.01） and the essential hypertension group（P0.05）,and also the IMT and PS were higher in the essential hypertension group than essential hypertension group.Conclusion： The degree of carotid artery atherosclerosis in the essential hypertension with IGT group was significantly higher than that in the essential hypertension group.The coexist of IGT and hypertension could accelerate the progress of atherosclerosis,and the mechanism may be associated with insulin resistance.