脑梗塞患者血清胰岛素抵抗与PAI-1关系的探讨

Relationship between serum insulin resistance and PAI-1 in patients with cerebral infarction

目的论证脑梗塞患者存在胰岛素抵抗(IR),并进一步探讨胰岛素抵抗与血浆纤溶酶原激活物抑制物-1(PAI-1)活性在脑梗塞形成中的可能关系。方法选择47例正常成年人(Ⅰ组)、48例脑梗塞(Ⅱ组)、42例脑梗塞伴2型糖尿病(Ⅲ组);分别测定血清胰岛素(IS)、C肽水平及血浆PAI-1、组织纤溶酶原激活物(t-PA)活性。结果(1)Ⅱ、Ⅲ组患者IS、C肽、PAI-1活性明显高于Ⅰ组。其中以Ⅲ组增高最明显。(2)Ⅱ组、Ⅲ组IS、C肽与PAI-1及IS与C肽间呈正相关。结论(1)IR可能参与了脑梗塞的发生。(2)脑梗塞血浆PAI-1活性增高与IS及C肽呈正相关,PAI-1活性增高导致血浆纤溶活性降低,可能是IR引起脑梗塞的中间环节。(3)IR及PAI-1活性增高可能是糖尿病并发脑梗塞的原因之一。

Objective To demonstrate the presence of insulin resistance (IR) in cerebral infarction so as to explore the relationship between IR and PAI-1 in cerebral infarction .Methods Serum plasminogen activator inhibitor-1 (PAI-1),tissue plasminogen activator (t-PA) activity, serum glucose, insulin (IS),C-peptide (CP) were determined in 47 controls (group Ⅰ), 48 non-diabetic cases with CBI(group Ⅱ) and 42 type Ⅱ diabetics with CBI(groupⅢ).Results (1)The PAI-1 was positively correlative with the IS and CP in group Ⅱ and Ⅲ.(2)The IS was positively correlative with the CP.Conclusion (1)IR might participate in the CBI.(2)The PAI-1 obvious correlates with the IS and CP. The increasement of PAI-1 causing reduction of serum plasminogen activator might be a intermediate process of IR and CBI.(3)IR and increasement of PAI-1 activity might be one of the most major reasons in the outcome of cerebral infarction with DM.