高血压患者血压变异性与胰岛素抵抗和左室肥厚的相关性

目的 探讨高血压患者血压变异性（BPV）对胰岛素抵抗OR）和左心室肥厚（LVH）的影响.方法 将56例高血压患者根据有无LVH分为LVH组30例及非LVH组26例,另选取30例健康体检者为对照组.所有患者均行24 h动态血压监测,计算出血压变异系数（CV）；测定空腹血糖及空腹胰岛素水平,计算胰岛素抵抗指数（Homa-Ⅱ）.结果 与对照组比较,高血压患者24 h SBP、dSBP、nSBP变异系数均增大,尤以高血压合并LVH者更明显（LVH组P＜0.01,非LVH组P＜0.05）;Homa-IR均显著增加（P＜0.01）.LVH组与非LVH组比较、非LVH组与对照组比较,24 h DBP、dDBP、nDBP变异系数差异均无统计学意义,但Homa-IR均增加（P＜0.05）.结论 高血压患者BPV与IR、LVH的形成密切相关,其对高血压患者靶器官损害有重要的预测和评估价值.

Correlation of blood pressure variability with insulin resistance and left ventricular hypertrophy in patients with hypertension.

Objective To explore the effect of blood pressure variability （BPV） on insulin resistance （IR）, left ventricular hypertrophy （LVH） in hypertensive patients. Methods Fifty-six hypertensive patients were divided into LVH group （n=30, hypertensive patients with LVH） and NLVH group （n=26, hypertensive patients without LVH）. Thirty healthy subjects were selected as the control group （NC group）. All patients underwent 24 hour ambula- tory blood pressure monitoring, and the coefficient of variation （CV） was calculated by dividing the standard devia- tion by mean blood pressure. The fasting blood glucose and fasting insulin levels were determined, and the insulin re- sistance index （Homa-IR） was calculated. Results Compared with NC group, the 24 h SBP, dSBP, nSBP CV in- creased in hypertensive patients, especially in LVH group （LVH group, P〈0.01; NLVH group, P〈0.05）. Homa-IR were significantly increased （P〈0.01）. 24 h DBP, dDBP, nDBP CV showed no significant difference between LVH group and NLVH group, as well as between NLVH group and NC group, but Homa-IR were significantly increased （P〈0.05）. Conclusion Blood pressure variability is closely associated with LVH and IR, which is of great value to the prediction and assessment of the target organ damage in hypertensive patients.