老年男性高血压患者内分泌失衡对心功能的影响

目的探讨老年男性高血压患者钙代谢激素、胰岛素代谢及肾素系统障碍与心脏功能的关系。方法应用彩色多普勒超声心动图检测了96例老年高血压患者的心脏收缩及舒张功能，用放射免疫法测定患者的甲状旁腺激素、胰岛素及血管紧张素和醛固酮水平，测定尿钙／尿肌酐及单光子吸收法测定骨密度。结果老年高血压患者尿钙排泄增加，骨密度下降，心肌重量增加，甲状旁腺激素水平升高且与左室射血分数显著负相关，血胰岛素水平升高且与二尖瓣口舒张晚期及早期血流峰值速度比(Av／Ev)正相关，与血钙显著负相关。Av／Ev显著升高。结论老年男性高血压患者存在钙代谢、胰岛素代谢和肾素系统功能异常，且与心脏功能密切相关，这可能是老年男性高血压患者心功能受损的另一机制。

Effect of hormone inbalance on cardiac function in elderly male hypertension

Objective To study the relationship between cardiac function and hormone inbalance in elderly male hypertensives. Methods Cardiac systolic and diastolic function were estimated by echocardiogram in 96 old patients with hypertension . We also determined fasting plasma parathyroid hormone (PTH) level, serum insulin level, angiotensin n level, aldoste-rone level by radioimmunoassay in these old patients. We determined also fasting urinary calcium to urinary creatinine ratio, bone density in these old patients. Results In old patients with hypertension, measurement of urinary calcium excretion was obviously higher and measurement of PTH level was obviously higher and closely related with left ventricular ejection fraction, measurement of serum insulin level was obviously higher and closely related with the ratios of peak late to early diastolic velocity (Av/Ev) and there were significantly negative correlation between serum insulin and serum calcium, measurement of Av/Ev was obviously higher. Conclusions Disturbance of calcium metabolism and insulin metabolism and function of RAAS were common , it is closely related to cardiac function. This is possible mechanism explaning cardiac dysfunction in old patients with hypertension.