冠心病患者胰岛素抵抗指数与炎症因子的相关性分析  

Relationship between level of IRI and inflammation factors in CHD patients

作　　者：梁卓燕[1] 郭文怡[1] 王海昌[1] 李飞[1] 秦涛[1] 范泉[1] 

机构地区：[1]第四军医大学西京医院心血管内科,陕西西安710033

出　　处：《心脏杂志》2006年第3期312-313,317,共3页Chinese Heart Journal

摘　　要：目的探讨冠心病患者胰岛素抵抗（IR）与炎症因子的关系及意义。方法收集114例拟行选择性冠状动脉造影（CAG）患者，分为正常对照组34例；单纯冠心病组52例；冠心病并发糖耐量异常及Ⅱ型糖尿病组28例。采用Backman全自动生化分析仪测定空腹血糖（FBG）、早餐后2h血糖（2hBG）、血脂等指标，用放射免疫法测定空腹胰岛素（FINS）、肿瘤坏死因子α（TNF-α）。根据HOMA Model计算胰岛素抵抗指数（IRI）=FINS×FBG／22．5。采用散射光比浊法测定C反应蛋白（CRP）。入院后2～5d内行CAG。结果冠心病并发糖耐量异常及Ⅱ型糖尿病组IRI、CRP、TNF-α水平均较正常对照组及单纯冠心病组显著升高（P〈0．01）；单纯冠心病组FINS、TNF-α水平均高于正常对照组（P〈0．05）；相关性分析显示，冠心病患者IRI与TNF—α、CRP呈正相关。结论冠心病患者存在胰岛素抵抗，CRP、TNF—α等炎症因子的水平增高，二者呈正相关，共同参与了冠心病并发糖耐量异常或Ⅱ型糖尿病患者的病情进展。AIM To explore the relationship between the level of insulin resistance index （IRI） and inflammation factors in coronary heart disease （CHD） patients. METHODS One hundred and fourteen patients were included in the study： control group （34）, simple coronary heart disease group （52）, and coronary heart disease with impaired glucose tolerance （IGT） and type Ⅱ diabetes mellitus （T2DM） group （28）. The levels of serum insulin, c-reactive protein （CRP）, and tumor necrosis factor -α（TNF-α） were analyzed respectively. All the patients also had coronary angiography and the extent of coronary artery injury was evaluated. RESULTS The levels of IRI, TNF-α and CRP in CHD accompanied with T2DM and IGT group were significantly higher than those of simple CHD group and control group （P 〈 0.01 ）. The levels of FINS and TNF-α in simple CHD group were higher than those of control group（P 〈 0.05 ）. Correlation analysis showed that the level of IRI was positively correlated with those of CRP and TNF-α in CHD patients. CONCLUSION Insulin resistance occurs in all CHD patients. The levels of IRI, TNF-α and CRP in CHD patients are high, especially in CHD patients accompanied with IGT and T2DM IRI.

关 键 词：冠状动脉疾病 胰岛素抵抗 炎症因子 肿瘤坏死因子Α C反应蛋白 

分 类 号：R541.4[医药卫生—心血管疾病]