胰岛素抵抗与急性脑梗死患者颈动脉内中膜厚度及神经功能缺损严重程度的相关性分析

目的探讨胰岛素抵抗（IR）与急性脑梗死患者颈动脉内中膜厚度（IMT）及神经功能缺损严重程度的相关性。方法75例急性脑梗死患者根据IMT值分为IMT〈1．0mm组（n=40例）和IMT≥1．0mm组（n=35例），根据临床神经功能缺损程度评分标准分为轻型组、中型组、重型组。比较各组空腹血糖（FPG）、空腹血清胰岛素（FINS）、纤维蛋白原（FIB）、载脂蛋白A蛋白（ApoA）等实验室指标，并计算胰岛素敏感指数（ISI）和胰岛素抵抗指数（HOMA．IR）。结果IMT≥1．0mm组患者FPG、FINS、HOMA．IR均明显高于IMT〈1．0mm组（P〈O．05），1SI明显低于IMT〈1．0mm组（P〈0．05），而各组ApoA、FIB比较差异无统计学意义（P〉0．05）；随着神经功能缺损程度逐渐加重，FPG、FINS、HOMA-IR明显升高（P〈0．05），而ISI明显降低（P〈0．05），而各组ApoA、FIB比较差异无统计学意义（P〉0．05）。结论IR与急性脑梗死患者颈动脉IMT及神经功能缺损严重程度密切相关，IMT越厚、神经功能缺损严重程度越重，则IR程度更强。

Objective To study the correlation of insulin resistance （ IK ） with carotid intima-media thickness （ IMT ） and the severity of nerve function defect patients with acute cerebral infarction. Methods 75 patients with acute cerebral infarction were divided into IMT〈1.0mm group （ n=40 cases ） and IMT〉1.0mm group （ n=35 cases ） according to IMT values, were divided into light group, medium group, heavy group according to the degree of clinical neural function defect score standard. The fasting plasma glucose （ FPG ） , fasting serum insulin （ FINS ） , fibrinogen （ FIB ） , apolipoprotein A （ ApoA ） protein and other laboratory index of all groups were compared.The insulin sensitive index （ ISI ） and insulin resistance index （ HOMA IR ） were calculated. Results The FPG, FINS, HOMA IR of IMT〉1.0mm group were significantly higher than that of the IMT〈1.0mm group （ P〈0.05 ） , and the ISI was lower than that in IMT〈1.0mm group （ P〈0.05 ） , and there was no statistical significance between the groups about ApoA, FIB （ P〉0.05 ） .With the nerve function defect degree aggravating, FPG, FINS, HOMA IR increased significantly （ P〈0.05 ） , while the ISI significantly decreased （ P〈0.05 ） , and there was no statistical significance between the groups about ApoA, FIB （ P〉0.05 ） . Conclusion IR has a closely relation to carotid artery IMT and the severity of nerve function defect of patients with acute cerebral infarction, the thicker the IMT is, the more severe the nerve function defect will be, the stronger degree of IR will be.