脑梗死患者血清胰岛素活性与PAI-1关系的探讨

Exploration of the relationship between serum insulin and PAI-1 in cerebral infarction

目的 论证脑梗死患者存在胰岛素抵抗 (IR) ,探讨 IR与血浆纤溶酶原激活物抑制物 - 1(PAI- 1)活性在脑梗死形成中的可能关系。方法 选择 47例正常成年人 (I组 )、48例脑梗死患者 (II组 )、42例脑梗死伴 II型糖尿病患者 (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可能参与了脑梗死的发生。 (2 )脑梗死血浆 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引起脑梗死的中间环节。 (3) IR及 PAI- 1活性增高可能是糖尿病并发脑梗死的原因之一。

Objective To demonstrate the presence of insulin resistance (IR) in cerebral infarction so as to explore the relationship between IR. PAI 1 and 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 positive correlated with the IS and CP in group II and III. The IS was positive correlated with the CP. Conclusion (1)IR might participate in the CBI.(2)The PAI 1 has obvious correlationship with the IS and CP. The increase of PAI 1 causing reduction of serum plasminogen activator might be a intermediate process between IR and CBI.(3)IR and increase of PAI 1 activity might be one of the most major reasons in the outcome of cerebral infarction with DM.