急性脑梗死致多器官功能障碍综合征C-反应蛋白与胰岛素抵抗的相关性

Relationship between the level of C-reactive protein and insulin resistance in patients with MODS caused by acute cerebral infarction

目的探讨急性脑梗死（ACI）致多器官功能障碍综合征（MODS）时C-反应蛋白（CRP）与胰岛素抵抗之间的关系。方法分别测定40例正常健康体检者（正常对照组）和72例ACI患者出现首发症状14d以内空腹血糖、胰岛素、CRP的含量，计算胰岛素敏感指数（ISI）。ACI患者中急性单纯性脑梗死（SACI组）44例，ACI致MODS（MODS组）28例。结果（1）SACI组及MODS组空腹血糖、胰岛素、CRP水平均显著高于正常对照组，ISI显著低于正常对照组，MODS组空腹血糖、胰岛素和CRP水平又显著高于SACI组，差异均有统计学意义。（2）SACI组与MODS组CRP及胰岛素的动态变化规律明显不同，MODS组为持续异常升高。（3）SACI组与MODS组CRP水平与胰岛素水平呈显著正相关，与ISI呈显著负相关。结论ACI致MODS时存在血CRP水平的异常增高和胰岛素抵抗，且胰岛素抵抗可导致CRP水平进一步上升，它们可能共同参与了MODS的发生及发展过程。

Objective To explore the relationship between C-reactive protein （CRP）and insulin resistanee（IR）in patients with multiple organ dysfunction syndrome（MODS）caused by acute cerebral infarction （ACI）. Method Fasting blood glucose, insulin and CRP were measured in 112 eases, including 40 nomud subjeets（eontrol group）, 44 simple ACI patients（SACI group）and 28 MODS patients caused by ACI （MODS group） ,and insulin sensitivity index（ISI）were calculated as well Results （ 1 ） The levels of fasting blood glucose, insulin and CRP in SACI group and MODS group were significantly higher than those in control group, ISI was significantly lower than that in control group. The levels of fasting blood glucose, insulin and CRP in MODS group was significantly higher than those in SACI group. （2） The dynamic change regulaxity of CRP and insulin were different in MODS group from SACI group, which increased continuously and abnormally. （3） In SACI group and MODS group there was a significant positive correlation between CRP and insulin levels, and there was a significant negative correlation between CRP and ISI levels. Conclusions The presence of the abnormal increase of CRP and IR in patients with MODS caused by ACI, and IR may cause the level of CRP to increase further. They may together take part in the initiation and progression of MODS caused by ACI.