脑梗死伴颅内动脉狭窄与胰岛素抵抗的关系  

Interrelation between insulin resistance and intracanial arterial stenosis in patients with cerebral infarction

作　　者：王香云[1] 殷为勇[1] 周成业[1] 

机构地区：[1]温州医科大学附属第一医院神经内一科,浙江温州325015

出　　处：《温州医科大学学报》2015年第12期899-902,共4页Journal of Wenzhou Medical University

基　　金：温州市科技计划项目(Y20120230)

摘　　要：目的:探讨脑梗死伴颅内动脉粥样硬化性狭窄与胰岛素抵抗(IR)的相关性。方法:选取2012年9月至2014年8月在温州医科大学附属第一医院神经内科住院的脑梗死患者,经头颅MRA证实有颅内动脉狭窄(至少一支血管狭窄率≥50%)的161例为狭窄组,无颅内血管狭窄或轻度狭窄(狭窄率<50%)的81例为对照组,分别测定收缩压(SBP)、舒张压(DBP)、尿酸(UA)、血同型半胱氨酸(HCY)、空腹血糖(FBG)、空腹胰岛素(FIN)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL),高密度脂蛋白(HDL)等指标,使用稳态模式评估法(HOMA)评价并利用工具计算胰岛素抵抗指数(HOMA2-IR)。分析上述指标在2组间的差异,及HOMA2-IR与其他指标的相关性。结果:颅内动脉狭窄组患者年龄、LDL-C、UA、FBG、FIN、HOMA2-IR水平均明显高于非狭窄组(P<0.05);经相关分析表明,HOMA2-IR与血压、TG、LDL呈正相关(P<0.05),多因素logistic回归分析表明LDL、UA、HOMA2-IR与颅内动脉粥样硬化性狭窄相关,是其危险因素(P<0.05)。结论:颅内动脉狭窄与HOMA2-IR有一定的正相关性,IR是颅内动脉粥样硬化性狭窄的独立危险因素之一。Objective： To evaluate the relationship between insulin resistance and intracanial arterial stenosis in patients with cerebral infarction. Methods： Two groups were studied： 1161 patients with potential intracanial arterial stenosis（grade≥50%, at least one vessel）; 281 subjects without intracanial arterial stenosis（grade50%）. Insulin resistance was determined by the steady state model evaluation method, special tool was used to calculate the evaluation index of insulin resistance. MRI and MRA was performed in all subjects. The severity of intracanial arterial stenosis was determined by the Warfarin-Aspirin Symptomatic Intracranial Disease Study（WASID）. Results： The homeostasis model assassment 2-insulin resistance（HOMA2-IR） was significantly higher in patients with intracanial arterial stenosis compared with control subjects. Based on logistic regression model, high HOMA2-IR was one of the risk factors. Conclusion： These results suggest that insulin resistance is a risk for intracranial arterial stenosis.

关 键 词：颅内动脉狭窄 胰岛素抵抗 胰岛素抵抗指数 

分 类 号：R743.1[医药卫生—神经病学与精神病学]