非糖尿病冠心病患者纤溶系统与胰岛素抵抗的相关性分析  

The relationship between fibrinolytic system and insulin resistance in non-diabetic patients with coronary artery disease

作　　者：史珂[1,2] 韩常宝[2] 王海玲[2] 王禹[1] 

机构地区：[1]解放军总医院老年心血管内科,北京100853 [2]解放军北京军区总医院263临床部心肾内科,北京101149

出　　处：《中国临床医生杂志》2014年第4期30-32,共3页Chinese Journal For Clinicians

摘　　要：目的探讨非糖尿病冠心病患者纤溶系统与胰岛素抵抗相关性。方法 200例接受冠脉造影检查的非糖尿病患者,根据冠脉病变支数,分为单支病变组、双支病变组、多支病变组和正常对照组,并测量血压、身高、体重,测定空腹血浆胰岛素(FINS)、空腹血糖(FPG)、纤溶酶原激活剂抑制因子-1(PAI-1)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C),计算体重指数(BMI)、稳态模型评估-胰岛素抵抗指数(HOMA-IRI)和Gensini积分。结果冠心病各组FINS、HOMA-IRI、PAI-1、TC、TG、LDL-C均显著高于对照组(P<0.05);随着冠脉病变程度增加,Gensini积分、HOMA-IRI、PAI-1均增加,且各组间差异有显著性(P<0.05);校正影响因素后进行偏相关分析,HOMA-IRI及PAI-1均与Gensini积分呈正相关(P<0.05);多元逐步线性回归分析显示:Gensini积分、PAI-1与HOMA-IRI独立相关,BMI、HOMA-IRI、Gensini积分与PAI-1独立相关。结论非糖尿病冠心病患者的胰岛素抵抗状态与纤溶系统异常状态同冠脉病变程度密切相关,且两者互为独立影响因素。Objective To investigate the relationship between fibrinolytic system and insulin resistance in non-diabet-ic patients with coronary artery disease. Method 200 non-diabetic patients received coronary angiography were en-rolled, who were divided into four groups according to the number of diseased vessels： one vessel diseased group, two vessels diseased group, three vessels diseased group and control group. The blood pressure, height and weight were measured. Plasma insulin （FINS）, fasting plasma glucose（FPG）, plasminogen activator inhibitor-1（PAI-1）, total cholesterol（TC）, triglycercide（TG） and low density lipoprotein cholesterol（LDL-C） were measured. Body mass index （ BMI） ,homeostasis model assessment of insulin resistance index （ HOMA-IRI） and Gensini＆#39;s score of coronary artery were calculated. Result Compared with the control group, FINS、HOMA-IRI、PAI-1、TC、TG、LDL-C levels in CHD groups increased significantly（P〈0. 05）;Gensini＆#39;s score、HOMA-IRI and PAI-1 were all significant-ly increased with the number of vessels involved;The differences among all groups were significant（P〈0. 05）;Par-tial correlations showed that HOMA - IRI and PAI-1 were both positively correlated with Gensini＆#39;s score （ P〈0. 05）after adjusting the influential factors;Multivariate linear regression model showed that Gensini＆#39;s score and PAI-1 were independent factors for HOMA-IRI;BMI,HOMA-IRI and Gensini〈39;s score were independent factors for PAI-1. Conclusion The degree of Insulin resistance and fibrinolytic system is closely correlated with the severity of coronary artery stenosis in non-diabetic patients with coronary artery disease,and that they are both independent factors for each other.

关 键 词：冠心病 胰岛素抵抗 纤溶系统 非糖尿病患者 

分 类 号：R541.4[医药卫生—心血管疾病]