Ⅱ型糖尿病病人高血压致病因子临床观察

对27例高血压性Ⅱ型糖尿病患者(组1)之高血压致病因子初步进行临床观察,以无高血压之Ⅱ型糖尿病(组2)46例,高血压病(组3)15例及健康人(组4)15例做为对照。测定项目包括OGTT,胰岛素释放试验,血浆心房利钠多肽(ANP),血管紧张素Ⅰ(ATI),血浆醛固酮(ALD),全血容量,尿蛋白定量等。发现高血压性Ⅱ型糖尿病组血浆胰岛素水平、血钠和全血容量显著高于组2,血浆ANP,水平显著低于组4,但无高血压的Ⅱ型糖尿病组也有类似情况,故钠水潴留并不能解释高血压的发病。与高胰岛素血症有关的其他致病因子还须进一步研究。

THE CLINICAL OBSERVATION OF THE PATHOGENITIC FACTORS OF HYPERTENSION IN PATIENTS WITH NIDDM

A part of pathogenetic factors of hypertensionin twenty--seven patients with hypertensive NIDDM (group 1) were observed. The control groupsincluded non-hypertensive NIDDM (group 2, n=46 ), primary hypertension (group 3, n= 15) andhealthy persons (group 4, n= 15). The oral glu-cose tolerance test (OGTT), insulin releasing test(IRT ), atrial natriuretic peptide (ANP), an-giotensin I (ATI), aldosterone (ALD), wholeblood volume and urine protein were measured.The results showed that the plasma insulin andsodium levels and the whole blood volume weresignificantly higher in group 1 than those in con-trol group 2, the ANP level was rather lower than that in control group 4. Although the results werecorresponded with the theory that the circulatinghyperinsulinemia may lead to sodium retention andinhibited an adequate ANP stimulation by sodiumchallenge which turn to hypertension, nonhyper-tensive NIDDM patients (group 2) also have thesame findinge. So the retention of sodium and wa-ter can't be used to explain the mechanism of hy-pertension in NIDDM patients, the other patho-genetic factors especialy the factors related to thehyperinsulinemia such as PGE and PGI need to beinvestigated futher.