胰岛素抵抗、血脂异常与急性脑梗死关系的初步研究

Study on the relationship between insulin resistance,lipid abnormality and acute cerebral infarction

目的 探讨胰岛素抵抗、血脂异常与急性脑梗死之间的关系。方法 对 45例急性脑梗死患者作空腹血糖 (FPG)、血清胰岛素 (FINS)及血脂测定 ,并与 2 5例原发性高血压 (EH)患者及 2 5例健康体检者比较。采用李光伟提出的方法计算胰岛素敏感性指数 (ISI) :为空腹血清胰岛素与空腹血糖乘积的倒数 ,即 1/(FINS×FPG) ,取其自然对数。结果 急性脑梗死患者FINS明显高于两对照组 (P <0 0 1) ;胰岛素敏感性指数明显低于两健康对照组 (P <0 0 1) ;TG、CHOL、apoB明显高于健康对照组 (P <0 0 1) ,HDL明显低于对照组 (P <0 0 1)。FPG、LDL及apoA1三组间无明显差异。结论 急性脑梗死存在胰岛素抵抗 ,胰岛素抵抗和血脂异常可能在脑梗死的发生中起重要作用。胰岛素抵抗在脑梗死中的重要作用有待于进一步深入研究。

Objective To investigati the relationship between insulin resistance (IR),blood lipid abnormality and acute cerebral infarction.Methods Fasting plasma glucose (FPG), fasting seruminsulin (FINS), hemoglobin-Alc (GHbAlc) and the blood lipid were measured in three groups: (1) Group A:45 patients with acute cerebral infarction; (2) Group B: 25 patients with essential hypertension as control; (3) Group C: 25 healthy volunteers as normal control. The method which Li Guangwei proposed to caculate the insulin sensitivity index (ISI) was adopted.Results The study showed that FINS were significantly higher whereas ISI was significantly lower in acute cerebral infarction group than those in the two controls (P<0.01); TG, CHOL and apoB were significantly higher whereas HDL was significantly lower in acute cerebral infarction group than in the healthy controls (P<0.01).And there were no significant difference in FPG,LDL and apoA1 in the three groups.Conclusion IR is existed in acute cerebral infarction,IR and lipid abnormality were probably played an important role in the pathologic process of cerebral infarction.The significance of IR in cerebral infarction needs to be further investigated.