冠心病与高胰岛素血症关系的探讨

Approach on the Relationship between Coronary Heart Disease and Hyperinsulinemia

为了探讨冠心病（ＣＨＤ）与高胰岛素血症（ＨＩＳ）的关系，本文分析了３４例冠心病和１５例正常人口服葡萄糖耐量试验（ＯＧＴＴ）前后血清胰岛素（ＩＳ）以及血清胰岛素／血糖比值（ＩＳ／ＳＧ），结果发现ＣＨＤ组服糖后１ｈ、２ｈ，ＩＳ水平均明显高于对照组（Ｐ＜０．０５），而空腹时ＩＳ无明显增高（Ｐ＞０．０５）；ＣＨＤ组ＨＩＳ发生率显著高于对照组（Ｐ＜０．０１），ＩＳ／ＳＧ却无明显增高（Ｐ＞０．０５）。提示：有ＨＩＳ的ＣＨＤ患者并不一定有胰岛素抵抗（ＩＲ），ＨＩＳ可以是ＣＨＤ发病的一种独立危险因素，可不通过血糖、血脂代谢异常、高血压发病。

In order to study the relation between the coronary heart disease and hyperinsulinemia,serum insulin and the ratio of serum insulin/blood suger were studied in 34 patients with coronary heart disease before and after oral glucose tolerance test compared with 15 normal persons. The results showed that the serum insulin of treatment group was higher than that of control group 1 or 2 hours after the test(P >0. 05) .but they had no difference before the test(P <0. 05). The rate of hyperinsulinemia of treatment group was higher than that of control group (P <0.01), but the ration of serum insulin/blood suger was not significantly raised (P >0.05). As a result,the insulin resistance did not necessarily exist in patients with coronary heart disease complicated by hypetinsulinemia. and hyperinsulinemia might not be an independent risk factor on the development of coronary heart disease without the manifestation of metabolic abnormalities of blood suger,lipid and hypertension.