缺血性脑卒中患者血浆胰岛素、瘦素水平的改变及其临床意义

The change and its clinical significance of plasma insulin sensitivity and leptin level in the patients with ischemic stroke

目的 探讨缺血性脑卒中患者血浆胰岛素、瘦素水平的改变及其临床意义。方法 测定31例动脉粥样硬化性血栓性脑梗死(ACI)、30例腔隙性脑梗死(LI)患者及21名健康对照者血浆胰岛素、瘦素、血糖及胰岛素敏感指数(ISI)等指标并作比较。结果 ACI组与对照组比胰岛素浓度(6.17±4.33μIU/ml)升高(P<0.05)、胰岛素敏感指数(-3.22±0.79)下降(P<0.05)。LI组与对照组比,无显著性差别(P>0.05)。血浆瘦素水平与胰岛素敏感指数呈负相关(男性r=-0.633、女性r=-0.503,均P<0.001)。伴高血压的男性脑梗死患者血浆瘦素水平显著高于男性对照组(P<0.05)。结论 胰岛素抵抗是ACI患者的危险因素,而高瘦素血症是胰岛素抵抗的重要组成部分。

Objective To investigate the change and its clinical significance of plasma insulin and leptin level in the patients with cerebral infarction.Methods The plasma leptin, insulin, glucose levels and insulin sensitivity index(ISI) of 31 patients with atherothrombotic cerebral infarction (ACI), 30 patients with lacunar infarction (LI) and 21 cases of healthy controls were determined. Results Compared with those in the controls, there were elevation of plasma insulin level (6.17 ± 4.33 μIU/ml, P < 0.05) and reduction of ISI ( - 3 .22 ± 0.79, P < 0.05) in the ACI patients, but no signifficant differences were found in LI patients. The plasma leptin level was related negatively to ISI in the stroke patients (male r = -0.633;female τ= -0.503, all P < 0.001). Male CI patients with essential hypertension showed significant elevation of plasma leptin level compared with that in the male controls( P < 0.05) . Conclusion Insulin resistance is a risk factor for ACI, and increased plasma leptin level plays an important role in pathogenesis of insulin resistance.