老年缺血性脑卒中患者的认知功能与胰岛素抵抗的关系

Relation between the cognitive function and insulin resistance in the elderly wi th ischemic stroke

目的:探讨老年缺血性脑卒中患者的认知功能与胰岛素抵抗(insulinre-sistance,IR的关系,为血管性痴呆的预防与治疗提供新的作用靶点。)方法:将中国医科大学第一附属医院老年病房2003-08/2004-03收治的88例缺血性脑卒中患者分为认知功能正常组(正常组,32例),轻度血管性认知功能障碍组(轻度异常组,35例),血管性痴呆组(21例);分别测定其空腹血糖(FBG)、空腹胰岛素(FINS)、C-肽及血压、血脂、体质量指数(BMI),计算其胰岛素敏感指数(ISI)、代谢综合征的发生率及IR的临床评分,进行对比研究。结果:ISI:轻度异常组为-4.29±0.58,血管性痴呆组为-4.96±0.61,均低于正常组-3.58±0.52;正常组、轻度异常组、血管性痴呆组IR的构成比(6%,14%,49%)及代谢综合征的发生率(12%,36%,46%)显著递增。结论:IR是老年缺血性脑卒中患者认知功能下降的重要危险因素。

AIM:To study the relationship between insulin resistance(IR) and cognitive fu nction in elderly patients with ischemic stroke. METHODS:Eighty eight elderly patients with ischemic stroke were selected fror m the First Affiliated Hospital of China Medical University from August 2003 to March 2004 and then divided into normal cognition group(normal group,n=32),mild vascular cognitive impairment(MVCI) group(n=35) and vascular dementia(VD) group( n=21).Their fasting blood glucose(FBG), serum C peptide, blood pressure, fastin g insulin(FINS), lipids, and body mass index(BMI)were assessed. Insulin sensit ivity index(ISI),rate of metabolic syndrome and clinical score of IR for each gr oup were calculated and compared. RESULTS:ISIs of MVCI group(-4.29±0.58) and VD group(-4.96 ±0.61) were sign ificantly lower than that of normal group(-3.58±0.52). The constituent ratio o f IR and the incidence of metabolic syndrome had a progressive increase in norma l group(6%, 12%), MVCI group(14%, 36%) and VD group (49%, 46%), respective ly. CONCLUSION:IR is an important risk factor for the cognitive impairment in elde rly patients with ischemic stroke.