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目的检测伴有胰岛素抵抗(IR)的高血压患者早期心功能状态,初步探讨Tei指数和B型利钠肽(BNP)评价此类患者心功能状况的临床价值。方法选取高血压伴IR患者30例,另选取不伴IR的高血压患者30例作为对照组。测定血浆脑钠肽水平、空腹血糖及空腹胰岛素水平,计算胰岛素抵抗指数(HomaIR)及胰岛素敏感指数(ISI),行超声心动图检查,计算Tei指数。结果①IR组与对照组相比,NT-proBNP差异无统计学意义(p>0.05),Tei指数及HomaIR显著增加(p<0.01),ISI显著降低(p<0.01);②Pearson相关分析显示:BNP与HomaIR、ISI、Tei指数均无明显相关性,r值分别为0.019(p>0.05)、0.016(p>0.05)、0.004(p>0.05)。Tei与HomaIR呈明显正相关,r值为0.344(p=0.008),Tei与ISI呈明显负相关,r值为-0.319(p=0.015)。结论高血压伴IR患者在左室收缩功能尚未发生改变时就可出现左室舒张功能障碍,Tei指数能敏感反映左室整体功能,且不易受外界因素的干扰,适宜早期评估高血压伴IR患者的整体心功能。
Objective To investigate the early cardiac function of hypertensive patients with insulin resistance (IR) and to explore the clinical value of Tei index and BNP in evaluating the cardiac function of these patients. Methods Thirty patients with hypertension and IR were selected. Thirty patients with hypertension without IR were selected as control group. The levels of plasma brain natriuretic peptide, fasting blood glucose and fasting insulin were measured. Homa IR and insulin sensitivity index (ISI) were calculated. The Tei index was calculated by echocardiography. Results ① There was no significant difference in NT-proBNP between the IR group and the control group (p> 0.05). The Tei index and HomaIR increased significantly (p <0.01) and ISI decreased significantly (p <0.01) .Pearson correlation analysis showed that BNP There was no significant correlation with HomaIR, ISI, Tei index, r values were 0.019 (p> 0.05), 0.016 (p> 0.05), 0.004 (p> 0.05). There was a positive correlation between Tei and HomaIR. The r value was 0.344 (p = 0.008). There was a significant negative correlation between Tei and ISI. The r value was -0.319 (p = 0.015). Conclusions Left ventricular diastolic dysfunction can occur in hypertensive patients with IR without change of left ventricular systolic function. Tei index can reflect the overall function of left ventricular in a sensitive way and is not easily disturbed by external factors. It is suitable for early assessment of hypertension with IR The overall heart function.