胰岛素抵抗对非糖尿病患者冠状动脉病变的影响  

Effects of insulin resistance on the severity of coronary artery lesions in the non-diabetic patients

作　　者：叶子青[1] 吴天凤[1] 乔松[2] 俞志红[2] 金海燕[2] 叶莉[2] 

机构地区：[1]浙江医院内分泌科,浙江杭州310013 [2]浙江医院干部保健科,浙江杭州310013

出　　处：《中国现代医生》2012年第17期66-69,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划(2011KYB021)

摘　　要：目的探讨非糖尿病患者胰岛素抵抗对冠状动脉病变的影响。方法收集非糖尿病可疑冠心病患者121例,分为NGT+IS(n=34)、NGT+IR(n=32)、IGR+IS(n=26)及IGR+IR(n=29)四组,检测心血管危险因子,进行选择性冠状动脉造影及Gensini评分,比较IR和IS两组间数据。结果 NGT+IR和IGR+IR组左前降支、左回旋支、右冠状动脉三支分支及总Gensini评分显著高于NGT+IS组;Spearman法及校正影响因素后偏相关分析显示Gensini评分与HOMA2-IRI均呈正相关(r1=0.370,r2=0.305,P<0.05);多元线性回归分析显示HOMA2-IRI是影响Gensini评分的独立因素。结论在非糖尿病患者中胰岛素抵抗影响冠状动脉病变程度,是其独立的危险因子。Objective To study the effects of insulin resistance on the severity of coronary artery lesions in the non-dia- betic patients. Methods A total of 121 consecutive non-diabetic patients suspected of coronary heart disease were divided into four groups：NGT＋IS（n = 34）,NGT＋IR（n = 32）,IGR＋IS（n = 26） and IGR＋IR group（n = 29）.Cardiovascular risk factors were measured, selective coronary angiography and Gensini score were performed for all patients. IS and IR groups＇ data were compared and studied. Results The total Gensini score and that of three hranehs,including left anterior de- scending branch,left circumflex artery,right coronary artery and in NGT＋IR and IGR＋IR groups were significantly higer than those in NGT＋IS group.Partial correlation analysis showed that Gensini score correlated significantly and positively with HOMA2-IRI （r = 0.370,P 〈 0.05） even after adjusting for influential faetors（r = 0.305 ,P 〈 0.05）. Multivariate lin- ear stepwise regression analysis indicated that HOMA2-IRI was an independent factor for Gensini score. Conclusion In- sulin resistance is closely correlated with the severity of coronary artery lesions and is an independent risk factor for coro- nary artery disease in non-diabetic patients.

关 键 词：胰岛素抵抗 冠状动脉疾病 正常糖耐量 糖调节受损 危险因素 

分 类 号：R587[医药卫生—内分泌] R543[医药卫生—内科学]