老年脑梗死患者高胰岛素血症的临床研究  

The relationship between cerebral infarction and hyperinsulinemia in the elderly.

作　　者：郭竹英[1] 顾锡华[1] 

机构地区：[1]上海第二医科大学附属宝钢医院内科

出　　处：《新医学》1999年第5期260-261,共2页Journal of New Medicine

摘　　要：目的：探讨高胰岛素血症（ＨＩＳ）、胰岛素抵抗（ＩＲ）与老年脑梗死发病的关系。方法：测定３４例６０岁以上老年脑梗死患者和２０名正常人的葡萄糖耐量试验（ＯＧＴＴ）后血糖、胰岛素及其曲线下面积（ＡＵＣ）和胰岛素／血糖、血脂变化。结果：脑梗死组糖负荷后血糖、胰岛素、胰岛素／血糖、ＡＵＣ以及总胆固醇明显高于对照组，胰岛素敏感性指数（ＩＳＩ）及ＨＤＬ－Ｃ明显低于对照组，糖负荷后１小时、２小时胰岛素及其ＡＵＣ与舒张压呈正相关，甘油三酯、总胆固醇与空腹和１小时胰岛素呈正相关。结论：老年脑梗死存在ＨＩＳ和ＩＲ，并可能通过影响血压和脂质代谢等而促进脑梗死的发病。Objective: To study the relationship among the hyperinsulinemia(HIS), insulin resistance(IR) and cerebral infarction. Methods: Oral glucose tolerance test(OGTT) and insulin release test were performed, and changes in plasma glucose and insulin level, area under the curve (AUC) of insulin, insulin/glucose ratio and lipid profile in 34 elderly patients (equal or more than sixty old) with cerebral infarction were compared with those in 20 normal control subjects . Results: Values of plasma glucose, insulin level, insulin/glucose ratio,AUC and total cholesterol were all significantly higher, but insulin sensitivity index( ISI) and HDL C were significantly lower in cerebral infarction group than those in control group after OGTT. At 1h and 2h after sugar load plasma, insulin levels and AUC of insulin were positively related to diastolic blood pressure, while triglyceride and total cholesterol were also shown positive correlated with plasma insulin levels at fasting and 1h after sugar load. Conclusions: Hyperinsulinemia and insulin resistance coexist in elderly patients with cerebral infarction may contribute to the development of cerebral infarction by affecting on blood pressure and lipid metabolism

关 键 词：高胰岛素血症 胰岛素抵抗 脑梗死 糖耐量试验 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R587.3[医药卫生—临床医学]