急性缺血性脑卒中患者血浆胰岛素、瘦素、内脂素水平的改变及其临床意义  

Changes of plasma insulin,leptin and visfatin levels in patients with acute ischemic stroke and their clinical significance

作　　者：李晶[1] 于奇晋 薛延华[1] 李定安[1] 张妮[2] LI Jing;YV Qijin;XUE Yanhua;LI Ding′an;ZHANG Ni(Department of Neurology,Central Hospital of Hanzhong,Hanzhong,Shaanxi 723000,China;Department of Rehabilitation,Second Affiliated Hospital of Xi′an Jiaotong University,Xi′an,Shaanxi 710004,China)

机构地区：[1]陕西省汉中市中心医院神经内科一病区,723000 [2]西安交通大学第二附属医院康复科,710004

出　　处：《重庆医学》2021年第20期3446-3449,共4页Chongqing medicine

基　　金：国家自然科学基金项目(81100985);陕西省汉中市中心医院院级科研基金中标项目(YK1924)。

摘　　要：目的对急性缺血性脑卒中患者中内脂素、瘦素、胰岛素的改变和临床意义进行探究。方法将2016年6-12月来陕西省汉中市中心医院就诊的216例急性缺血性脑卒中患者设为A组,并根据是否合并2型糖尿病(T2DM)分成A1组(合并T2DM,100例)和A2组(不合并T2DM,116例),同时选择同期来该院体检的136例健康人员设为B组。收集不同人群临床资料,对比不同时间A、B两组血清瘦素水平、内脂素水平、空腹胰岛素水平。结果A、B两组的年龄、性别、体重指数、高密度脂蛋白比较差异无统计学意义(P>0.05)。A组的舒张压、收缩压、体脂含量、腰臀比、总胆固醇、三酰甘油、低密度脂蛋白都高于B组(P<0.05)。在入院第1、3、7、14天,A组的低密度脂蛋白、总胆固醇、空腹血糖、胰岛素抵抗指数、胰岛素、内脂素、瘦素均大于B组(P<0.05)。A1组、A2组的胰岛素抵抗指数在入院第3天均达到峰值,瘦素水平、胰岛素水平在入院第7天均达到峰值。A1组入院第7天,内脂素水大于A2组,入院第3、7、14天瘦素水平大于A2组(P<0.05)。A1组入院第1、3、7、14天的胰岛素水平、胰岛素抵抗指数均大于A2组(P<0.05)。结论内脂素、胰岛素、瘦素水平同急性缺血性脑卒中的发生可能存在一定相关性,在急性缺血性脑卒患者中,合并T2DM的瘦素、胰岛素水平显著高于未合并T2DM者。Objective To explore the changes and clinical significance of visfatin,leptin and insulin in patients with acute ischemic stroke.Methods A total of 216 patients with acute ischemic stroke treated in Central Hospital of Hanzhong from June 2016 to December 2016 were selected as group A.According to whether they have type 2 diabetes mellitus(T2DM),they were divided into group A1(100 cases with T2DM)and group A2(116 cases without T2DM),and at the same time,136 healthy people who came to this hospital for physical examination during the same period were selected as group B.The clinical datas of patients in different groups were collected,and the serum leptin level,visfatin level,and fasting insulin level between groups A and B were compared at different times.Results There were no significant differences in age,gender,BMI,and high-density lipoprotein between groups A and B(P>0.05).The diastolic blood pressure,systolic blood pressure,body fat level,waist-to-hip ratio,total cholesterol,triglycerides,and low-density lipoprotein in group A were all higher than those in group B(P>0.05).On the first,third,seventh,and fourteenth days after admission,the low-density lipoprotein,total cholesterol,fasting blood glucose,insulin resistance index,insulin,prolactin,and leptin in group A were all higher than those in group B(P>0.05).The insulin resistance index of groups A1 and A2 reached the peak on the 3rd day after admission,and the leptin and insulin levels reached the peak on the 7th day after admission.On the 7th day after admission,the visfatin level of group A1 was greaterthan that of group A2,and the leptin levels on the 3rd,7th,and 14th days after admission were higher than those of group A2(P<0.05).The insulin level and insulin resistance index on the 1st,3rd,7th,and the 14th day after admission in group A1 were higher than those in group A2(P<0.05).Conclusion The levels of visfatin,insulin,and leptin may be related to the occurrence of acute ischemic stroke.In patients with acute ischemic stroke,the leptin level of patie

关 键 词：急性缺血性脑卒 内脂素 瘦素 胰岛素 临床意义 

分 类 号：R743.3[医药卫生—神经病学与精神病学]