老年缺血性脑血管病患者胰岛素抵抗、血脂异常及TNF-α的临床研究  

Clinical study on relationship between insulin resistance, lipid abnormality and tumor necrosis factor-α in patients with ischemic cerebral vascular disease

作　　者：耿纪录[1] 李炜[2] 盛春燕[1] 李晓利[1] 苏轮[1] 贾金兰[1] 刘芳[1] 赵丽娟[1] 

机构地区：[1]解放军第309医院干部病房,北京100091 [2]解放军316医院,北京100093

出　　处：《中国药物应用与监测》2004年第3期8-11,共4页Chinese Journal of Drug Application and Monitoring

摘　　要：目的:探讨胰岛素抵抗(IR)、血脂异常及肿瘤坏死因子-α(TNF-α)与老年人缺血性脑血管病发病之间的关系。方法:观察了28例急性脑梗死患者、19例恢复期脑梗死患者及26例正常对照者的SBP、DBP,并测定其FBG、FINS、C肽、TC、TG、LDL-C、HDL-C、ApoA1、ApoB及TNF-α。按FBG与FINS乘积的负自然对数法计算胰岛素敏感性指数(ISI)。结果:与对照组比较,急性脑梗死组FBG、FINS和C肽明显高于对照组,P<0.01。ISI则明显低于对照组,P<0.05。恢复期脑梗死组与对照组比较,FBG、FINS及C肽有所升高,ISI有所下降,但除FINS有统计学显著差异外,其余P值均>0.05。以对照组胰岛素相对敏感性为100％,急性脑梗死组和恢复期脑梗死组的胰岛素相对敏感性分别为43％和68％。急性脑梗死组与对照组比较,SBP、DBP、TG、LDL-C、ApoB、TNF-α均明显升高,HDL-C、ApoA1显著降低,P<0.05或P<0.01。而恢复期脑梗死组与对照组比较,除SBP、TG有统计学显著差异外,余项指标P值均>0.05。急性脑梗死组与恢复期脑梗死组比较,SBP、TG进一步升高,P<0.05。急性脑梗死组ISI与SBP、DBP、TG、LDL-C、ApoB、TNF-α呈显著负相关,与HDL-C呈显著正相关。结论:IR、血脂异常、TNF-α与缺血性脑血管病发病密切相关,改善胰岛素敏感性对防治缺血性脑血管病有益。Objective:To investigate the relationship between insulin resistance,lipid abnormality and tumor necrosis factor-α(TNF-α)in patients with ischemic cerebral vascular disease. Methods: Systolic blood pressure (SBP), diastolic blood pressure (DBP),fasting blood glucose(FBG),fasting insulin(FINS),C peptide,total cholesterol (TC),triglyceride (TG) ,LDL,HDL,Apoprotein (Apo)A1,ApoB and TNF-α were measured in 28 patients with acute cerebral infarction (group 1), 19 patients with cerebral infarction in the recovery stage (group 2) and 26 healthy controls. FINS, C peptide and TNF-α were determined by radioimmunoassay. And insulin sensitivity index (ISI) was calculated as In[1/( FBGxFINS)].Results:FBG, FINS,C peptide, SBP,DBP,TG.LDL,ApoB and TNF-α in group 1 were significantly higher than that of the controls, then ISI、HDL and ApoA1 were significantly lower than that of the controls, respectively ,P<0.05 or P<0.01 .But in group 2, only SBP and TG had significant difference with the controls. Compared with group 2, SBP and TG in group 1 increased significantly. Multiple regression analysis indicated that ISI in group 1 was significantly negatively related to SBP,DBP,TG,LDL,ApoB,TNF-α,while it correlated with HDL positively. Conclusion: Insulin resistance, dislipidemia and TNF-α may contribute to the pathogenesis of ischemic cerebral vascular disease.

关 键 词：缺血性脑血管病 胰岛素抵抗 血脂异常 肿瘤坏死因子-Α 

分 类 号：R743.9[医药卫生—神经病学与精神病学]