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目的探讨胰岛素抵抗对合并高血压慢性肾病患者心室肥厚及颈动脉粥样斑块硬化的影响。方法选取100例合并高血压慢性肾病患者,测定患者血糖、胰岛素水平及颈总动脉内膜中层厚度、平均斑块数、颈动脉斑块形成率、左心室质量(LVM)、左心室质量指数(LVMI),比较胰岛素抵抗组患者(RI组,45例)与非胰岛素抵抗组患者(NRI组,55例)颈动脉血管超声检查结果和心室肥厚组(58例)与非心室肥厚组(42例)左室质量。结果 RI组胰岛素抵抗指数和颈总动脉内膜中层厚度、平均斑块数、颈动脉斑块形成率均显著高于NRI组,差异具有统计学意义(P<0.05);心室肥厚组胰岛素敏感指数显著低于非心室肥厚组,LVM和LVMI显著高于非心室肥厚组,差异具有统计学意义(P<0.05)。结论胰岛素抵抗参与合并高血压慢性肾病患者心室肥厚及颈动脉粥样斑块硬化形成,在临床治疗中具有重要指导意义。
Objective To investigate the effect of insulin resistance on ventricular hypertrophy and carotid atherosclerosis in patients with chronic kidney disease complicated by hypertension. Methods 100 patients with CHD were enrolled in this study. Blood glucose, insulin levels, carotid artery intima-media thickness, average plaque count, carotid plaque formation rate, left ventricular mass (LVM), left ventricular mass index LVMI). The results of carotid artery ultrasonography and ventricular hypertrophy (n = 58) and non-ventricular hypertrophy (n = 42) were compared between insulin resistance group (n = 45) and non-insulin resistance group Left ventricular mass. Results Insulin resistance index and carotid artery intima-media thickness, mean plaque number and carotid plaque formation rate in RI group were significantly higher than those in NRI group (P <0.05). Insulin sensitivity index Significantly lower than non-ventricular hypertrophy group, LVM and LVMI was significantly higher than non-ventricular hypertrophy group, the difference was statistically significant (P <0.05). Conclusion Insulin resistance is involved in the formation of ventricular hypertrophy and carotid atherosclerosis in patients with hypertension and chronic nephropathy. It plays an important guiding role in clinical treatment.