脑梗死患者体内胰岛素抵抗和红细胞胰岛素受体的关系(英文)  

Relationship between insulin resistance and erythrocyte insulin receptors in patients with cerebral infarction

作　　者：于明[1] 陈罕[1] 赵晴[1] 邬英全[1] 

机构地区：[1]吉林大学中日联谊医院神经内科,吉林省长春市130033

出　　处：《中国临床康复》2005年第41期160-161,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：背景:流行病学研究显示胰岛素水平升高和冠状动脉疾患相关,代谢研究也表明胰岛素抵抗、高胰岛素血症和非胰岛素依赖性糖尿病、高血压、肥胖及脂质紊乱密切相关。目的:探讨脑梗死患者体内胰岛素抵抗与红细胞胰岛素受体之间的关系。设计:病例-对照观察。单位:吉林大学中日联谊医院神经内科。对象:选择40例2004-01／10在吉林大学中日联谊医院住院的脑梗死患者。同时选取了30例健康的医护人员作为对照组。方法:检测脑梗死患者和对照者的空腹血糖、血清胰岛素及葡萄糖耐量试验后2 h的血糖、血清胰岛素浓度,并将空腹血糖和血清胰岛素浓度的乘积作为胰岛素抵抗指标。采用改良甘氏法检测红细胞胰岛素受体, 同时分析胰岛素受体数目与胰岛素抵抗指标的关系。主要观察指标:脑梗死组与正常对照组:①空腹及葡萄糖耐量试验后2 h 血糖和血清胰岛素的比较。②胰岛素抵抗指标比较。③红细胞胰岛素受体分析。结果:40例脑梗死患者和30例对照者的数据均进入结果分析,无脱落者。①空腹及葡萄糖耐量试验后2 h血糖和血清胰岛素的比较:脑梗死组空腹血清胰岛素、葡萄糖耐量试验后2 h血糖和胰岛素均大于正常对照组[(13．30±5．15),(9．85±4．36)mU/L,(8．27±1.65),(6．32±1．37)mmol／L, (75．21±21.12),(28．26±6．31)mU／L,P<0．01,P<0．001]。②胰岛素抵抗指标比较:脑梗死组大于正常对照组(68．69±22．91,48．36±10．16,P<0．001)。③红细胞胰岛素受体分析:脑梗死组每个红细胞膜胰岛素高、低两型亲和力受体数目及最大特异性结合率均小于正常对照组[20．30±4．50, 23．80±4．10;2 223．80±509．30,2 610．10±435．10;(10．62±3．55)％, (13．21±2．94)％,P均<0．01];直线回归与相关分析表明脑梗死患者胰岛素高、低两型亲和力受体数目与胰岛素抵抗指标呈负相关(r=-0．458, -0．439,PBACKGROUND： Epidemiologic studies have shown an association between higher insulin levels and coronary artery disease, and metabolic studies have associated insulin resistance and compensatory hyperinsulinemia with non-insulin-dependent diabetes mellitus, hypertension, obesity, and lipid disorders. OBJECTIVE： To investigate the relationship between insulin resistance （IR） and erythrocyte insulin receptors （EIRs） in the patients with cerebral infarction （CI）. SETTING： Department of Neurology, China-Japan Union Hospital of Jilin University. PARTICIPANTS： From January 2004 to October 2004, 40 patients with CI, who were in-patients in China-Japan Union Hospital of Jilin University, were selected for the study. Meanwhile, 30 healthy doctors or nurses were recruited as normal controls. METHODS： The levels of blood glucose and serum insulin under fasting and 2-hour after oral glucose tolerance test （OGTT） were detected in the 40 patients with CI and 30 healthy doctors or nurses. Fasting blood glucose multiplied by fasting serum insulin was insulin resistance index （IRI）. The number of insulin receptors and their binding affinity on every erythrocyte were determined using modified Gambhir＇s method. The correlation between the number of EIRs and IRI was analyzed. MAIN OUTCOME MEASURES： Comparison of CI group with control group in： ① the level of blood glucose, serum insulin under fasting and 2hour after OGTT; @ 1RI;② EIRs. RESULTS： Data of 40 patients with CI and 30 controls were analyzed, and none was lost. ① Comparisons of the level of blood glucose, serum insulin under fasting and 2-hour after OGTT： The level of serum insulin under fasting and blood glucose, serum insulin at 2-hour after OGTT in CI group were higher than those in normal group [（13.30±5.15）, （9.85±4.36） mU/L, （8.27±1.65）, （6.32±1.37） mmol/L, （75.21±21.12）, （28.26±6.31）mU/L,P 〈 0.01, P 〈 0.001]. ②Comparison of IRI： IRI in CI group was higher than that in normal group （6

关 键 词：脑梗塞 抗药性 受体 胰岛素 

分 类 号：R743[医药卫生—神经病学与精神病学]