代谢综合征合并冠心病患者胰岛素抵抗与血浆纤溶活性的关系

Relationship between insulin resistance and plasma fibrinolytic activity in coronary heart disease with metabolism syndrome

目的 探讨代谢综合征 (themetabolismsyndrome,MS)合并冠心病 (coronaryheartdisease,CHD)患者的胰岛素抵抗 (insulinresistance,IR)与血浆纤溶活性的关系。方法 选择单纯代谢综合征患者 31例 ,代谢综合征合并冠心病患者 36例和正常对照 2 0例 ,观察一般情况 ,并测定血浆纤溶酶原激活物抑制物 1(plasminogenactivatorinhibitortype 1,PAI 1)、纤维蛋白原 (fibrinogen ,Fg)、空腹血糖 (fastingbloodglucose ,FBG)、空腹血胰岛素 (fastinginsulin ,FINs)和血脂等指标 ;计算胰岛素敏感指数 (insulinsensitiveindex ,ISI)。结果 代谢综合征合并冠心病组的ISI较单纯代谢综合征组及正常对照组明显下降 (P <0 .0 5 ) ;血浆PAI 1、Fg等明显升高 (P <0 .0 5 )。在代谢综合征合并冠心病组PAI 1与Fg、FINs正相关 ,与ISI、高密度脂蛋白 (highdensitylipoprotein ,HDL)负相关 ,多元回归分析显示 ,ISI、HDL和Fg与PAI 1独立相关。 结论 代谢综合征合并冠心病患者存在明显的胰岛素抵抗和纤溶活性异常 ,同时纤溶活性异常与胰岛素抵抗相关。

Objective To investigate the relationship between insulin resistance(IR) and plasma fibrinolytic activity in coronary heart disease with the metabolism syndrome. Methods We selected 31 patients with the simply metabolic syndrome(MS group), 36 patients in coronary heart disease with the metabolism syndrome(CHD-MS group) and 20 normal subjects. Anthropometric measures,lipid profiles, PAI-1, Fg, FBG, FINs were measured. And insulin sensitivity was determined by insulin sensitive index(ISI).Results Compared with normal group and the simply MS group, ISI in the CHD-MS group was lower(P< 0.05), PAI-1 and Fg were higher(P< 0.05) and PAI-1 positively correlated with FINs and Fg, negatively correlated with ISI and HDL. Using PAI-1 as a dependent variable in a stepwise regression analysis, ISI,HDL and Fg were independently correlated with PAI-1. Conclusion Abnormal PAI-1 correlated significantly with insulin resistance in CHD-MS patients.