合并OSAHS的老年急性脑梗死患者同型半胱氨酸和胰岛素抵抗临床分析  

The clinical analysis of homocysteine and insulin resistance in acute cerebral infarction elderly patients with obstractive sleep apnea-hypopnea syndrome

作　　者：李刚[1] 胡亚梅[1] 刘建锋[1] 张红菊[1] 向莉[1] 侯亚辉[1] 靳培军 罗之云 

机构地区：[1]河南省人民医院暨郑州大学人民医院神经内科,河北郑州450003

出　　处：《中风与神经疾病杂志》2017年第2期126-129,共4页Journal of Apoplexy and Nervous Diseases

基　　金：郑州市金水区科技攻关项目(2013)26号

摘　　要：目的研究合并阻塞性睡眠呼吸暂停综合征(OSAHS)的老年急性脑梗死(ACI)患者血清同型半胱氨酸(Hcy)及稳态模型胰岛素抵抗指数(HOMA-IR)水平,分析老年ACI患者OSAHS、Hcy和HOMA-IR相互关系。方法根据年龄和睡眠呼吸监测数据,将患者分为老年ACI+OSAHS组(n=21)、老年ACI组(n=30)、中年ACI+OSAHS组(n=28)和中年ACI组(n=34),检测并比较各组血清Hcy、胰岛素抵抗指数(HOMA-IR)等各指标。结果老年ACI+OSAHS组较其余3组的Hcy和HOMA-IR均升高,差异有统计学意义(P<0.05);中年ACI+OSAHS组较中年ACI组Hcy和HOMA-IR增高,差异有统计学意义(P<0.05)。Hcy与年龄、AHI、平均腰围、BMI、HOMAIR均呈正相关;多元线性回归分析显示AHI与年龄、Hcy、HOMA-IR、BMI呈正相关。结论随年龄的增加,合并OSAHS的急性脑梗死患者Hcy和HOMA-IR水平随之升高;OSAHS可能通过升高Hcy及增加胰岛素抵抗导致ACI。Objective To investigate the levels of homocysteine （ Hey） and insulin resistance in acute cerebral in-farction （ACI） elderly patients with obstractive sleep apnea syndrome （OSAHS） , and analysis the relationships of them. Methods The participants were divided into the elderly ACI ＋ OSAHS group （n =21） , elderly ACI group （n = 3 0 ） ,mid-dle-aged ACI ＋ OSAHS group （n=2S） and middle-aged ACI group （n = 3 4 ） according to the age and results of polysom-nography. The serum Hey and insulin resistance （ HOMA-IR） were detected, then analysis the relationship of OSAHS, Hey and HOMA-IR. Results The Hey and HOMA-IR levels in elderly ACI ＋ OSAS group were higher than this in other groups （P 〈0.05） ;the Hey and HOMA-IR levels in middle-aged ACI ＋ OSAS group were higher than this in middle-aged ACI groups （P〈0. 05） ;the Hey levels were positively correlated with the ag e , AHI, waist circumference, BMI and HOMA-IR levels;and the AHI were positively correlated with the age,Hey,HOMA-IR levels and BMI. Conclusion The Hey and H0- MA-IR levels increased with the advancing age in ACI elderly patients with OSAHS;OSAHS may affect the Hey and insulin resistance levels,then causes ACI.

关 键 词：急性脑梗死 阻塞性睡眠呼吸暂停综合征 同型半胱氨酸 胰岛素抵抗 老年 

分 类 号：R743.3[医药卫生—神经病学与精神病学]