溶栓治疗对急性心肌梗死患者胰岛素敏感性的影响  

Effect of thrombolytic therapy on the change in insulin resistance in patients with acute myocardial infarction

作　　者：刘四海[1] 贾国良[2] 郭文怡[2] 

机构地区：[1]甘肃武威解放军第十医院内二科,733000 [2]第四军医大学西京医院心内科,陕西西安710032

出　　处：《心脏杂志》2000年第2期96-97,99,共3页Chinese Heart Journal

摘　　要：探讨溶栓治疗对急性心肌梗死 (AMI)患者空腹胰岛素及胰岛素抵抗的影响。检测 2 0例溶栓治疗和 2 2例未溶栓治疗的非糖尿病 AMI患者的空腹血糖 ,空腹胰岛素及胰岛素敏感性指数 ,并与 2 0例正常人作比较 ,AMI患者 4周后复查。结果 :AMI两组在急性期存在高胰岛素血症和胰岛素抵抗 ,4周后复查血胰岛素水平 ,胰岛素敏感性指数较急性期有明显下降 (P<0 .0 1) ,AMI溶栓治疗组的空腹胰岛素和胰岛素敏感性指数较未溶栓治疗组显著下降 (P<0 .0 5 )。结论 :AMI存在高胰岛素血症及胰岛素抵抗 ,以急性期最明显 。To investigate whether there were difference betweenn the serum insulin(Ins) and insulin sensitivity index (ISI) in acute myocardial infarction (AMI) patients with thrombolytic therapy and those in AMI patients with nonthrombolytic therapy,the concentrations of fasting blood glucose (FBG),Ins were measured in 20 non diabetic AMI patients with thrombolytic therapy,22 non_diabetic AMI patients with non thrombolytic therapy and 20 healthy controls. The ISI of each group was calculated and compared. The FBG and Ins of AMI patients were again measured 4 weeks latter. Both of the AMI groups had a significantly greater mean FBG and Ins and ISI than those of the control group in acute period. The Ins and ISI of the AMI groups had a significantly drop in the following 4 weeks ( P <0.01). Compared with the AMI patients of non thrompolytic therapy,the AMI patients with thrombolytic therapy showed low Ins and ISI ( P <0.05). The AMI patients suffered hyperinsulinemia and insulin resistance which were more significant in acute period. Thrombolytic therapy can decrease Ins and ISI.

关 键 词：溶栓治疗 心肌梗死 急性 胰岛素抗药性 

分 类 号：R542.220.5[医药卫生—心血管疾病]