心脏X综合征患者胰岛素抵抗及其与内皮素和一氧化氮相关性研究  

A study on insulin resistance and the relationship between insulin resistance and endothelin or nitric oxide in patients with cardiological syndrome X

作　　者：胡兆霆 杨钧国[2] 王祥[2] 何勇[2] 刘俐[2] 黄润青[2] 

机构地区：[1]广州邮电医院心内科,广州510630 [2]华中科技大学同济医学院心血管病研究所华中科技大学同济医学院附属协和医院心内科,武汉430022

出　　处：《临床心血管病杂志》2001年第4期170-172,共3页Journal of Clinical Cardiology

摘　　要：目的 :研究 X综合征 (X- Syn)患者的胰岛素敏感性 (ISS)及其与内皮素 (ET)、一氧化氮 (NO)的关系 ,探讨胰岛素抵抗 (IR)在 X- Syn发病中的作用。方法 :对 16例 X- Syn患者进行葡萄糖耐量试验 (OGTT) ,胰岛素释放曲线观察 ,并计算曲线下面积 ,同时采用放射免疫法和硝酸还原酶法分别测定空腹血浆 ET、NO水平 ,并与空腹胰岛素水平 (FIS)及胰岛素敏感性指数 (ISI)进行直线相关分析。结果 :与正常对照组比较 ,X- Syn患者 ISS降低及 ISI升高 (P <0 .0 5 ) ;血浆 ET和 NO水平升高 (P <0 .0 5 ) ,FIS及 ISI与血浆 ET呈显著正相关 (P <0 .0 5 ) ,ISS与 ET呈显著负相关 (P<0 .0 5 ) ,与 NO水平无相关 (P>0 .0 5 )。正常对照组的上述指标之间无相关(P >0 .0 5 )。结论 :X- Syn患者存在 IR,IR与血浆 ET水平升高有关 ,与 NO的关系有待进一步探讨。Objectives: To study insulin resistance and the relationship between insulin resistance and endothelin or nitric oxide in patients with cardiological syndrome X and to investigate the role of insulin resistance in pathophysiology of syndrome X.Method:Serum glucose and insulin were measured during oral glucose tolerance test (OGTT) and their area under the curve was also calculated.The level of fasting plasma immunoreactive endothelin (ET) was measured by radioimmunoassay. Serum nitric oxide (NO) was measured by nitroatreducase method in 16 patients with syndrome X and in 20 patients with coronary heart disease and in 20 healthy volunteers as control.Result:Insulin sensitivity (ISS) in patients with syndrome X was significantly lower,but fasting serum insulin concentration (FIS), insulin sensitivity index (ISI), ET and NO were significantly higher than those in healthy volunteers (ISS, 0.34 ± 0.04 vs 0.24 ± 0.03 ,FIS, 14.11 ± 1.32 vs 5.05 ± 0.62 ,ISI, 2.01 ± 0.66 vs 1.52 ± 0.13 ,All P< 0.05 ).In patients with syndrome X, FIS and ISI were significantly correlated with ET concentration and negative correlation between ISS and ET was found (r= -0.56 , P< 0.05 ),but there was no correlation between NO and ISI or ISS and FIS.Conclusinon:These results indicate that patients with syndrome X exist insulin resistance and hyperinsulinemia, which may correlate with endothelial dysfunction.On the other hand,the relation between insulin resistance and NO remains to be investigated further.

关 键 词：X综合征 胰岛素抵抗 内皮素 一氧化氮 相关性 

分 类 号：R541.02[医药卫生—心血管疾病] R587[医药卫生—内科学]