胰岛素抵抗与高血压并脑梗死关系的探讨

Primary study of the relationship of insulin resistance with essential hypertension and cerebral infarction

目的 探讨高血压并脑梗死患者是否存在胰岛素抵抗（ＩＲ）与高胰岛素血症（ＨＩＳ），以及ＩＲ与脑大小血管病变的关系。方法 测定５７例高血压并脑梗死患者及１５例非脑血管病患者的血糖（ＦＰＧ）与血清胰岛素（ＦＩｎｓ），同时采用李光伟等提出的胰岛素敏感性指数（ＩＳＩ）方法进行计算。结果高血压并脑梗死患者ＦＩｎｓ明显高于对照组（Ｐ＜０．００１），其ＩＳＩ较对照组明显减低（Ｐ＜０．００１）。脑微小血管病变组ＦＩｎｓ明显高于大血管病变组（Ｐ＜０．００１）。其ＩＳＩ较大血管病变组明显减低（Ｐ＜０．００１）。结论高血压并脑梗死存在ＩＲ，ＩＲ可能是其独立危险因素，脑微小血管病变可能直接与ＩＲ、ＨＩＳ有关。

Objective To investigate whether essential hypertensin and cerebral infarction is associated wtih insulin resistance (IR) and Hyperinsulinjsm (HIS),and the correlation between IR and patient with stroke due to large vessel disease and cerebral microangiopathy. Method Fasting plasma glucose (FPG)and insulin (FIns) were measured in two groups: (1) 57 cases with essential hypertension and cerebral infarction; (2) 15 cases with other neurological diseases except for cerebral vascular disease. Analysed by Li Guang-wei. Reuslt FIns was significantly higher and ISI was significantly lower in (1) group than (2) group (P<0.001). FIns was significantly lower in patients with stroke due to large vessel disease (P＜O. 001). Conclusion IR is existed in essential hypertension and cerebral infarction. IR is probably the independent risk factor in essential hypertension and cerebral in- farction. Cerebral microangiopathy is directly related with IR and HIS.