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目的探讨甘肃地区原发性高血压(EH)病人胰岛素抵抗(IR)在各级医院中的阳性率及其与生活方式的相关性。方法采用流行病学横断面调查研究,内容包括问卷、体检和生化指标三部分。采集病人年龄、性别、身高、体重、血压、相关病史及中医症状,并检测血糖、血脂及胰岛素水平,结合四诊情况进行中医辨证,对相关数据进行统计分析。结果 1筛选出IR病人1 036例,胰岛素抵抗(IRI)为51.8%;2各级医院EH病人中医证型分布不同,但均以肝火亢盛型最多;3社区医院就诊EH病人IR阳性率最高,与二级医院、三级医院比较差异有统计学意义(P<0.05);4吸烟与否、运动量不同与IR阳性率差异无统计学意义,经常饮酒病人IR阳性率高于不饮酒病人,肥胖病人IR阳性率显著高于无肥胖病人。结论 EH病人50%以上均存在IR;各级医院EH病人中医证型分布不同,IR阳性率亦不同;经常饮酒及肥胖的EH病人IR阳性率偏高。
Objective To explore the positive rate of insulin resistance (IR) in patients with essential hypertension (EH) in Gansu Province at all levels of hospitals and its relationship with lifestyle. Methods The epidemiological cross-sectional investigation, including questionnaires, physical examination and biochemical indicators of three parts. The patients’ age, gender, height, weight, blood pressure, related medical history and TCM symptoms were collected. The blood glucose, blood lipid and insulin levels were measured. The syndromes of TCM were analyzed according to the four diagnostic criteria. The data were statistically analyzed. Results 1 There were 1 036 IR patients and 51.8% insulin resistance (IRI). 2 There were different distribution of TCM syndromes in EH patients at all levels, (P <0.05) .4 There was no significant difference between smoking and non-smoking, the difference of exercise amount and the positive rate of IR. The positive rate of IR in regular alcohol consumption patients was higher than that in non-alcohol consumption patients, Obese patients with positive rate of IR was significantly higher than non-obese patients. Conclusions More than 50% of patients with EH have IR. Different TCM syndrome types of EH patients at different levels have different IR positive rates. The positive rate of IR in EH patients who regularly consume alcohol and obesity is high.