脑梗死患者胰岛素抵抗与血浆同型半胱氨酸水平的相关性分析

Analysis of the Correlation between Insulin Resistance and Plasma Homocysteine Level in Patients with Cerebral Infarction

目的探讨急性脑梗死患者胰岛素抵抗程度及其与血浆同型半胱氨酸(Hcy)水平的相关性。方法随机选取2013年7月-2014年8月确诊的100例脑梗死患者(脑梗死组)和100例健康体检者(对照组)进行空腹血浆Hcy水平检测,观察两组研究对象Hcy负荷情况,同时检测空腹血糖和空腹胰岛素水平,计算胰岛素抵抗指数(HOMA-IR)。结果脑梗死组和对照组血浆Hcy水平分别为(34.95±14.55)、(8.84±2.27)μmol/L,HOMA-IR分别为6.24±3.15、2.19±0.63,差异均有统计学意义(P<0.05)。按是否有脑梗死和是否有胰岛素抵抗分为4组,脑梗死-胰岛素抵抗组的血浆Hcy水平高于另外3组,脑梗死-非胰岛素抵抗组的血浆Hcy水平高于非脑梗死的2组,差异有统计学意义(P<0.05);非脑梗死组中有无胰岛素抵抗患者血浆Hcy水平差异无统计学意义(P>0.05)。脑梗死组中,胰岛素抵抗与血浆Hcy水平均呈正相关(r=0.600,P<0.01)。结论血浆Hcy水平与胰岛素抵抗对脑梗死的发生具有协同作用,改善胰岛素抵抗和降低血浆Hcy水平可能是降低脑梗死发病率的有效途径。

Objective To analyze insulin resistance in patients with cerebral infarction and its correlation with plasma homocysteine level.Methods A total of 100 cerebral infarction patients diagnosed between July2013 and August 2014 and 100 healthy physical examination subjects were included in our research.The plasma homocysteine level was detected;the levels of fasting plasma glucose and fasting insulin were detected at the same time.Results Plasma homocysteine level（34.95 ± 14.55） μmol/L in patients with cerebral infarction was significantly higher than that of the control group（8.84 ± 2.27） μmol/L（P〈0.05）.Insulin resistance index（6.24 ± 3.15） in patients with cerebral infarction was significantly higher than that of the control group（2.19 ± 0.63）（P〈0.05）.The plasma homocysteine level in the infarction group with insulin resistance was significantly higher than that in the infarction group without insulin resistance（P〈0.05）.The plasma homocysteine level in the infarction group without insulin resistance was significantly higher than that of the patients with insulin resistance in the control group（P〈0.05）.In the cerebral infarction group,insulin resistance index was positively correlated with plasma homocysteine level（r= 0.600,P〈0.01）.Conclusions Insulin resistance and plasma homocysteine level play important roles in clinical cerebral infarction.Improving insulin resistance and decreasing plasma homocysteine level may be effective ways to reduce the incidence of cerebral infarction.