高血压性脑出血患者胰岛素抵抗的临床研究  

The Clinical Study on Insulin Resistance of Hypertensive Intracerebral Haemorrhage

作　　者：刘建辉[1] 冀凤云[1] 王婷[1] 房树志[1] 解旭东[1] 王健[1] 姚斌[1] 

机构地区：[1]河北省保定市解放军252医院神经内科,0710000

出　　处：《脑与神经疾病杂志》2000年第2期72-74,共3页Journal of Brain and Nervous Diseases

摘　　要：目的:探讨高血压性脑出血(HIH)患者是否存在胰岛素抵抗(IR)与高胰岛紊血症(HIS),以及IR与患者病情、预后的关系。方法:测定了56例高血压性脑出血患者及37例原发性高血压患者、49例健康人的血糖(FPG)与血清胰岛素水平(FINS),同时采用胰岛素敏感性指数(ISI)方法进行计算,3个月后随访高血压性脑出血患者,进行日常生活能力(ADL)Barthel指数评分。结果:高血压性脑出血患者FPG及FINS增多明显高于对照组(P<0.001,P<0.001),其ISI较对照明显减低(P<0.001)。高血压性脑出血患者轻型组与重型组的FPG、FINS、ISI比较也存在显著性差异(P<0.001,P<0.05,P<0.001)。随访高血压性脑出血患者轻型组ADL评分明显高于重型组。结论:高血压性脑出血患者存在IR及HIS,其胰岛索水平及IR程度与患者病情、预后有关。建议对高血压性脑出血患者的血糖水平升高与IR及ISI下降者应积极使用改善胰岛素敏感性的药物治疗。Objective: To explore whether there are insulin resistance(IR)and hyperinsulinemia(HIS) . , in the patients with hypertensive intracerebral haemorrhage (HIH ), and the relationship between IR and the patients conditions and prognosis. Methods: Fasting plasma glucose(FPG) and fasting serum insulin level (FINS) were determined in 56 patients with hypertensive intracerebral haemorrhage. and the method which caculate the insulin sensitivity index (ISI)was adopted. We had evaluated the Barthel index (BI) from activities of daily living scale (ADD when the patients were suffered from HIH three months later. Results: The study showed that FPG and FINS of the patents group were significantly higher than those of the control groups ( P < 0. 001, P <0. 001), and ISI in the patients group was significantly lower than the control groups ( P <0. 001). There were significant differences in FPG FINS ISI between the mild group and severe group form HIH( < 0. 001, P < 0. 05, P < 0. 001 ). Aad the evaluation in the mild group was signifiantly higher than that of the severe group. Conclusion: There were IR and HIS in the patients with HIH, and a positive correlation was found between ISI and patients conditions and prognosis. It was suggested that drug therapy on the patients with high plasma glucose level and IR should be applied to improve ISI.

关 键 词：高血压性脑出血 胰岛素抵抗 ISI 

分 类 号：R743.34[医药卫生—神经病学与精神病学]