静脉盐负荷对高血压盐敏感者肾脏PGI2及TXA2的影响及盐敏感性高血压的胰岛素抵抗

摘要/Abstract

摘要： 目的观察急性静脉盐水负荷对高血压盐敏感者肾脏PGI₂及TXA₂的影响及盐敏感性高血压的胰岛素抵抗情况。方法测定53例已确定盐敏感性的高血压患者急性盐水负荷前后24h尿6-酮PGF₁α及TXB₂的排泄量,并在受试者中进行葡萄糖耐量及胰岛素释放试验。结果静脉盐水负荷后,盐敏感者24h尿6-酮PGF₁α的排泄量明显较盐不敏感者为低[(316±57)vs(371±68)pg/min,P<0.01],负荷后的减少幅度前者明显高于后者[(197±99)vs(136±101)pg/min,P<0.01]。而盐负荷后盐敏感者尿TXB₂的排泄量及负荷后的增加幅度均明显较盐不敏感者为高[(394±32)vs(359±44)pg/min,P<0.01;(80±47)vs(47±45)pg/min,P<0.01]。盐敏感者空腹及糖负荷后各时点血糖、血胰岛素水平均显著高于盐不敏感者(P<0.05),而胰岛素敏感性指数则明显低于盐不敏感者(0.013±0.003vs0.018±0.004,P<0.01)。结论急性静脉盐水负荷对高血压盐敏感及盐不敏感者肾脏PGI₂及TXA₂代谢的影响有明显差异,使高血压盐敏感者肾源性PGI₂减少而TXA₂增加,此异常可能与盐敏感性高血压的发病有关;盐敏感者胰岛素抗性较盐不敏感者高。

Abstract: Objective To investigate insulin resistance and the effects of intravenous acute saline load on renal production of prostaglandin I2 (PGI₂) and thromboxane A₂ (TXA₂) in salt-sensitive hypertensive patients. Methods The 24-hour excretion of urinary 6-keto-prostaglandin F (PGF) 1α and thromboxane B₂ were measured before and after intravenous acute saline load in 53 hypertensive patients whose salt sensitivity had been determined. Oral glucose tolerance test and insulin release test were performed in all the subjects. Results after intravenous acute saline load, the 24-hour excretions of urinary 6-keto PGF 1α were significantly lower in salt-sensitive (SS) hypertensive patients than that in non-salt-sensitive (NSS) ones (316±57 pg/min vs 371±68 pg/min, P<0.01), and the decrease from baseline was much greater in SS group than that in NSS group (197±99 pg/min vs 136±101 pg/min, P<0.01). Both 24 hour urinary excretion of TXA₂ and the increase in urinary excretion of TXA₂ were significantly greater in SS hypertensive patients than those in NSS ones after salt loading (394±32 pg/min vs 359±44 pg/min, P<0.01, and 80±47 pg/min vs 47±45 pg/min, P<0.01, respectively). The plasma glucose and insulin concentrations in every time point were much higher in SS hypertensive subjects than that in NSS ones, and the former group had lower insulin sensitivity index than the latter (0.013±0.003 vs 0.018±0.004, P<0.01). Conclusion Saline load produces significantly different effects on renal production of PGI₂ and TXA₂ in SS and NSS hypertensive patients, and these changes may be related to the pathophysiology of SS hypertensive patients after acute salt loading. Insulin resistance is greater in SS hypertensive patients than in NSS ones.

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R544.1

叶涛, 刘治全, 刘杰, 朱丹军, 郑勇. 静脉盐负荷对高血压盐敏感者肾脏PGI₂及TXA₂的影响及盐敏感性高血压的胰岛素抵抗[J]. 南方医科大学学报, 2005, 25(01): 102-105.

YE Tao, LIU Zhi-quan, LIU Jie, ZHU Dan-jun, ZHENG Yong. Insulin resistance and effects of intravenous acute saline load on renal production of prostaglandin I₂ and thromboxane A₂ in salt-sensitive hypertensive patients[J]. Journal of Southern Medical University, 2005, 25(01): 102-105.

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静脉盐负荷对高血压盐敏感者肾脏PGI₂及TXA₂的影响及盐敏感性高血压的胰岛素抵抗

Insulin resistance and effects of intravenous acute saline load on renal production of prostaglandin I₂ and thromboxane A₂ in salt-sensitive hypertensive patients

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