脑梗死患者胰岛素抵抗状态与血脂代谢异常(英文)

Insulin resistance and dyslipidosis in patients with cerebral infarction

目的:研究脑梗死患者的胰岛素抵抗状态与血脂代谢异常。方法:测定2000-05/09在中国医科大学附属二院住院的44例脑梗死患者的血脂、血糖、胰岛素及C-肽,与健康对照组(20例)比较。结果:脑梗死合并高血压组与不合并高血压组的空腹胰岛素(fastinginsulin,FINS)、C-肽、三酰甘油、高密度脂蛋白(high-densitylipoprotein,HDL)、载脂蛋白B(apolipoproteinB,ApoB)、胰岛素敏感指数(insulinsensitivityindex,ISI)与对照组比较有显著性差异(P<0.01),空腹血糖(FBS)、总胆固醇(TC)、低密度脂蛋白(low-densitylipoprotein,LDL)与对照组比较差异有显著性意义(P<0.05)。脑梗死两组间差异无显著性意义(P>0.05)。ISI与FINS(r=-0.82～-0.71,P<0.001),C-肽(r=-0.55～-0.53,P<0.01),ApoB(r=-0.46～-0.45,P<0.05)及神经功能缺损评分(r=-0.56～-0.58,P<0.01)呈显著负相关,与HDL(r=0.50～0.55,P<0.05)呈显著正相关。结论:脑梗死患者存在胰岛素抵抗,胰岛素抵抗与血脂代谢异常关系密切。

AIM:To study insulin resistance(IR)and blood lipid abnormality in patients with cerebral infarction. METHODS:Forty four patients with cerebral infarction,selected from Second Affiliated Hospital,China Medical University from May 2000 to September 2000,were enrolled to detect blood lipid,glucose,insulin and C peptide as compared with 20 healthy controls. RESULTS:In cerebral infarction patients with or without hypertension,fasting insulin(FINS),C peptide,triglyceride(TRIG),high density lipoprotein(HDL), apolipoprotein B(ApoB)and insulin sensitivity index(ISI)were significantly different from those in the control group(P< 0.01).Fasting blood sugar(FBS),total cholesterol(TC)and low density lipoprotein(LDL)were also different between the two groups(P< 0.05).No difference was showed between the patients with hypertension and those without hypertension(P >0.05).ISI was negatively correlated with FINS(r=-0.82--0.71,P< 0.001),C peptide (r=-0.55--0.53,P< 0.01), ApoB (r=-0.46--0.45,P< 0.05)and neurological deficits (r=-0.56--0.58,P < 0.01),however,positively correlated with HDL(r=0.50-0.55,P < 0.05). CONCLUSION:IR exists in patients with cerebral infarction,which is closely correlated with blood lipid abnormality.