冠心病患者胰岛素抵抗和钙离子代谢障碍  

Insulin resistance and dysbolism of calcium ions in patients with coronary heart diseases

作　　者：楚英杰[1] 牛振民[1] 孙济川[2] 田清海[2] 

机构地区：[1]河南省人民医院心内科,郑州450003 [2]西安医科大学第二附属医院心内科

出　　处：《临床心血管病杂志》2000年第7期297-299,共3页Journal of Clinical Cardiology

摘　　要：目的 :观察冠心病 ( CHD)患者的胰岛素抵抗 ( IR)状态、钙离子代谢障碍及其关系。方法 :测定 CHD组( 31例 )和正常对照组 ( 14例 )的胰岛素敏感性指数 ( ISI)、红细胞膜离子泵活性、红细胞总钙浓度和环磷酸腺苷( c AMP)浓度。结果 :CHD患者存在 IR和钙离子代谢障碍 ,表现为 ISI绝对值、红细胞总钙浓度、c AMP浓度升高和红细胞膜离子泵活性下降 ;31例 CHD中 15例 ( 48% )有高胰岛素血症 ;上述指标在有、无并发高血压者间相比无显著性差异。多元回归分析显示 :高密度脂蛋白、极低密度脂蛋白和 c AMP浓度是与 ISI密切相关的因素 ;红细胞膜 Na+- K+泵活性与 ISI呈正相关 ;红细胞膜 Ca2 +- Mg2 +泵活性与红细胞总钙浓度呈负相关。结论 :1CHD患者存在高胰岛素血症、IR和钙离子代谢障碍 ;IR是独立于高血压之外的 CHD致病因素。2 IR与钙离子代谢障碍有关 ,c AMP浓度增加可能是Objective:To study the status of insulin resistance (IR) ,dysbolism of calcium ions (DCI) and their relation in coronary heart diseases (CHD). Method:Insulin sensitivity (ISI), total concentration of Ca in erythorcytes (〔Ca 2+ 〕t), the concentration of cyclic adenosine monophosphate (CEcAMP) and the activity of the ion pump in the erythrocytic membrance were measured in 31 patients with CHD and 14 normal subjects.Result:There were IR and DCI existed in the patients which appeared as the elevation of the absolute value of ISI, 〔Ca 2+ 〕t and CEcAMP and decrease of the activity of the ion pump in the erythrocytic membrane. 15 of the 31 patients had hyperinsulinemia. The indexes mentioned above were almost the same in CHDs with hypertension and those without hypertension. Multivariate regression analysis suggested that the close correlative factors to ISI were high density lipoprotein, very low density lipoprotein and CEcAMP.ISI was positively correlated with the activity of the Na+K+ pump in erythrocytic membrane while 〔Ca 2+ 〕t was negatively correlated with the activity of the Ca 2+ Mg 2+ pump in erythrocytic membrane. Conclusion:①CHDs have hyperinsulinemia, IR and DCI; IR is an independent factor for CHD besides hypertension. ②IR is correlated with DCI and the elevation of CEcAMP may be one of the causes for IR occurrence.

关 键 词：胰岛素抵抗 钙离子代谢障碍 冠心病 

分 类 号：R541.406[医药卫生—心血管疾病] R587[医药卫生—内科学]