急性脑血管病患者胰岛素抵抗和血清胰岛素抗体水平的临床观察

Clinical observation on insulin resistance and insulin antibody level in the patients with cerebrovascular disease

目的观察急性脑血管病患者胰岛素抵抗(IR)和血清胰岛素抗体(IAb)水平变化,并分析其临床意义。方法采用放射免疫法测定36例急性脑梗死(ACI)、32例急性脑出血(ACH)、30例急性脑血管病恢复期患者(简称恢复组)及30名健康对照者的空腹血胰岛素和IAb水平,同时检测空腹血糖、血脂水平,计算胰岛素敏感指数(ISI)。结果 ACI组及ACH组血胰岛素和IAb水平显著高于恢复期及健康对照组(P<0.05),而ISI值显著低于恢复组和健康对照组(P<0.01);ACH组ISI高于ACI组(P<0.05).而两组间血胰岛素和IAb水平无统计学差异(P>0.05)。结论 IR及IAb可能参与了急性脑血管病的发病过程。IR参与脂质代谢紊乱过程,可能是脑卒中的独立危险因素之一。

Objective To observe the insulin resistance and serum insulin antibody （IAb） level in the patients with acute cerebrovascular disease, and to analyze their clinical meanings. Methods The levels of fasting serum insulin （INS） and lAb were determined by radioimmunoassay in 36 patients with acute cerebral infarction （ACI）, 32 patients with acute cerebral hemorrhage （ACH）, 30 patients at the convalescent stage and 30 healthy controls. The levels of blood glucose and blood lipid were measured, and insulin sensitivity index （ISI） was calculated. Results Compared with patients at the convalescent stage and the controls, INS and IAb levels were significantly higher （P〈0.05）, but ISI was lower （P〈0.01） in ACI and ACH patients. ISI was significantly higher in ACH patients than that in ACI patients （P〈0.05）, while there were no differences of INS and lAb levels between these two groups （P〈0. 05）. Conclusions Insulin resistance and IAb may be involved in pathogenesis of acute cerebrovascular disease. Insulin resistance participates in the process of lipid metabolic disorder, and might be one of the independent risk factors of eerebrovascular disease.