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目的探讨高血压患者胰岛β细胞早期分泌功能变化与高血压病程和分级的关系。方法确诊高血压患者106例,按病程与分级分为初诊组35例,5年内组34例,5年以上组37例;高血压1级组53例,2级组30例,3级组23例。治疗前行OGTT,测空腹和餐后30min血糖、胰岛素、C肽、尿素氮、肌酐及尿白蛋白等。计算HOMA-IR、早期胰岛素分泌指数(△I_(30)/△G_(30))的变化。结果 (1)β细胞早期分泌时相在高血压5年以上组出现损害,分泌量较初诊组和5年内组分别减少43%和40%,在高血压各分级组无明显差异(P>0.05)。(2)随着高血压病程和分级增加,胰岛素抵抗及蛋白尿也逐渐加重。结论高血压病程5年以上,3级高血压均与β细胞早期分泌功能和肾损害相关。
Objective To investigate the relationship between the changes of early secretory function of pancreatic β cells and the course and classification of hypertension in hypertensive patients. Methods A total of 106 patients with hypertension were divided into three groups based on their course of disease and grading: 34 cases in the first 5 years, 37 cases in 5 years or older, 53 cases in the first grade of hypertension, 30 cases in the second grade and 23 in the third grade. example. OGTT before treatment, fasting and postprandial blood glucose 30min, insulin, C peptide, urea nitrogen, creatinine and urinary albumin. The changes of HOMA-IR, early insulin secretion index (△ I_ (30) / △ G_ (30)) were calculated. Results (1) The early phase of β-cell senescence was impaired in hypertensive group for more than 5 years. The secretion of β-cell was 43% and 40% lower than that of the newly diagnosed group and the 5-year group respectively. There was no significant difference in the grading of hypertension group (P> 0.05 ). (2) With the course of hypertension and grading increased, insulin resistance and proteinuria also gradually increased. Conclusions The course of hypertension over 5 years and grade 3 hypertension are all related to the early secretory function and renal damage of β cells.