原发性高血压伴左心室肥厚病人的胰岛素抵抗和红细胞内钙离子代谢

目的比较原发性高血压（ＥＨ）伴左心室肥厚（ＬＶＨ）和无ＬＶＨ病人各３０例的胰岛素抵抗（ＩＲ）和细胞内游离钙浓度（［Ｃａ２＋］ｉ）的变化。用口服葡萄糖前后血浆胰岛素浓度（Ｉ）和Ｉ与血糖（Ｇ）比值来判断ＩＲ。用Ｆｕｒａ－２荧光染料测定红细胞内Ｃａ２＋。结果（１）ＬＶＨ糖负荷后的Ｉ及Ｉ／Ｇ均显著高于ＬＶＨ（－）；（２）ＬＶＨ的红细胞内Ｃａ２＋在空腹和糖负荷后均显著高于ＬＶＨ（－）；（３）ＬＶＨ的左心室重量指数（ＬＶＭＩ）与Ｉ及Ｉ／Ｇ呈正相关，ＬＶＨ（－）的ＬＶＭＩ仅与糖负荷后１ｈ的Ｉ及Ｉ／Ｇ正相关，ＬＶＨ和ＬＶＨ（－）两组的ＬＶＭＩ与红细胞内Ｃａ２＋正相关。结论ＥＨ病人伴ＬＶＨ时ＩＲ和红细胞内Ｃａ２＋增加。

Left Ventricular Hypertrophy,Insulin Resistance and Erythrocyte Intracellular Calcium in Patients with Essential Hypertension

Aim\ To investigate the relationship of the insulin resistance,erythrocyte intercellular calcium between the left ventricle hypertrophy in hypertensive patients.\ Methods\ The insulin resistance (IR) and erythrocyte intracellular free calcium concentration (Ca 2 ]i) in thirty essential hypertensive (EH) patients with left ventricular hypertrophy (LVH) were studied and compared with 30 age and sex matched EH patients without LVH. IR was assessed by indices derived from oral glucose tolerance test (OGTT). The plasma insulin level (I) and insulin/glucose ratio(I/G) were determined at 1 and 2 hours after glucose load. The erythrocyte intracellular Ca 2 was measured using the fluorescent indicator Fura-2AM.\ Results\ (1)Plasma I and I/G ratio the 1 and 2 hours OGTT were significantly higher in EH patients with LVH than those in EH patients without LVH. Either fasting or after glucose load erythrocyte intracellular Ca 2 were significantly higher in EH patients with LVH than those without LVH; (2)Either fasting or after glucose load plasma I and I/G ratio were correlated positively with LVMI in EH patients with LVH, but only plasma I and I/G ratio at one hour after glucose load were correlated positively with LVMI in EH patients without LVH. Erythrocyte intracellular Ca 2 at fasting or after glucose load were correlated positively with LVMI in EH patients with or without LVH. \ Conclusion\ That increased IR and intracellular Ca 2 may be associated with LVH in hypertensive patients.