医源性不同胰岛素剂量对中年2型糖尿病患者合并冠状动脉事件的作用  

Effects of Remedy-Given Insulin with Different Dosage on the Trigger Action On Coronary Events in the Middle Aged Type-2 Diabetes Mellitus

作　　者：王旭开[1] 杨成明[1] 王红勇[1] 付春江[1] 方玉强[1] 石伟彬[1] 张晔[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所心血管内科,重庆市400042

出　　处：《中国动脉硬化杂志》2005年第3期345-347,共3页Chinese Journal of Arteriosclerosis

基　　金：国家自然科学基金资助课题(30170384)

摘　　要：目的探讨医源性胰岛素不同剂量对中年2型糖尿病患者合并冠状动脉事件的发生是否存在相关关系。方法对53例使用胰岛素治疗的中年2型糖尿病并伴发冠状动脉事件的患者进行血清胰岛素和C肽测量,均行冠状动脉造影检查。分别以病变冠状动脉记分和病变冠状动脉支数为因变量,血清胰岛素和C肽为自变量,进行单元直线相关分析和多元逐步回归分析。另选32例未用胰岛素治疗的2型糖尿病病人作为对照组。结果伴发冠状动脉事件组血清胰岛素水平显著高于对照组,该组病人日均胰岛素用量多数在30IU以上。冠状动脉事件组胰岛素及C肽与病变冠状动脉记分呈显著正相关,病变冠状动脉支数与血清胰岛素和C肽呈正相关,并有浓度递增关系。逐步回归分析显示血清胰岛素和C肽与冠状动脉病变程度独立相关。结论冠状动脉病变程度与胰岛素及C肽呈正相关。血清胰岛素和C肽与冠状动脉病变程度独立相关。医源性胰岛素的剂量对2型糖尿病合并冠状动脉事件的病理生理急性改变存在显著的相关关系。Aim To explore the effects of remedy-given insulin with a different dosage on the onset of coronary events in middle aged type-2 diabetes mellitus. Methods 53 middle-aged type-2 diabetes mellitus eases who were received insulin treatment with coronary heart disease were processed with insulin and peptic C measure and angiagraphy. The coronary lesions and involved vessel score were repectively analysed using linea regression study, And another 32 type-2 diabetes mellitus without insulin regimen were placed in control group. Samples were analyzed with immunoreactiveinsulin and peptides C. Correlation between these variety scores for coronary lesions and 3 insulin sensitivity parameters was respectively obtained using linear regression analysis, and the stepwise regression analysis was used to assess dependence of associations, Results Serum insulin levels in coronary events group was significantly higher than those in control group. Most patients in coronary group consumed insulin more than 30 IU each day. Insulin and peptide C in coronary group was correlated with coronary lesion score or diseased vessel score. And the correlation was still significant with the insulin consumed consistance. Stepwise regression analysis showed that insulin and peptide C were independently correlated with the severity of coronary lesions. Conclusions The severity of coronary lesions was positively correlated with insulin and peptide C, Remedy-given hyperinsulinimia is only independently correlated with coronary events trigger in those type-2 diabetes mellitus. There might be certain association in the acute pathophysiology process of coronary lesion events.

关 键 词：内科学 医源性疾病 胰岛素 C肽 冠状动脉病变 冠状动脉事件 2型糖尿病 

分 类 号：R5[医药卫生—内科学]