脑卒中胰岛素抵抗的临床分析  

Clinical analysis of insulin resist in cerebral apoplexy

作　　者：茅志中 郭江宏[1] 

机构地区：[1]江苏省如皋市人民医院内科,江苏如皋226500

出　　处：《河北医学》2003年第8期699-701,共3页Hebei Medicine

摘　　要：目的 :评价脑出血与脑梗死病人体内的胰岛素抵抗 (IR)是否存在及有无差异 ,是否与脑部病变的严重程度有相关性 ;方法 :将脑卒中病人按照性质分为两组 :脑溢血组 ,脑梗塞组 ,①于病程恢复期 (3～ 4周 )时分别进行空腹血浆胰岛素浓度及血糖浓度测量 ,计算胰岛素敏感性指数 (IAI) ,取正常体检者作为对照组 ,对比各型脑卒中的IR程度之间及与正常人之间的差异。②应用多明田公式计算脑部损坏的体枳 ,分析其与脑卒中病人的胰岛素抵抗程度的相关性 ;结果 :①出血组与梗死组的IAI值均明显低于正常 (p <0 .0 1 )。②出血组的IAI值与脑梗死组存在差异 (p <0 .0 5 )。③梗死组病人的脑部损坏体积与脑梗死病人的IAI值呈负相关 (r=- 0 .4 332 ,p <0 .0 1 ) ,与出血组的相关性不明显 (r=- 5 .4 332 ,p >0 .0 5 )。结论 :①脑卒中病人体内存在不同程度的IR现象是患者本身所固有 ,也是造成该疾病发作的根本原因。②IR的程度与疾病的性质有明显的关系。③在脑梗死组 。Objective: To evaluate that if there are some difference in insulin resistance (IR) between cerebral hemorrhage and cerbral infraction, and if there are some realationship between the degree of cerebral destroy and insulin resist. Method: Divide cerebral apoplexy patients into two groups according their character: the group of cerebral hemorrhage and cerebral infraction. and measure their insulin strength (Ins) and blood sugar (BS) level in their recovery period (3～4weeks), and calculate insulin acute index(ISI).Calculate the destroyed volume of cerebral by use expressions of domintin and analyse the relationship between destroyed volume and level of IR.Results: ①The value of IAI in both of two groups are lower than infraction group obviously(P<0.01)?②The value of IAI in hemorrhage group is lower than infraction group obviously(P<0.01)? ③There are negative relationship between destroyed volume and IAI value in group of cerebral infraction( r=-0.4332,P<0.01), and there are no obviously relationship in the group of cerebral hemorrhage(r=-5.4332, P<0.05).Conclusion: ①The phenonenon of insulin resist is unique in cerebral apoplexy ,and is the essential reason of cerebral apoplexy. ②There are obviously relationship between the degree of IR and the character of cerebral apoplexy. ③In the group of cerebral infraction, there are positive relationship between the degree of IR and destroyed volume of cerebral.

关 键 词：脑梗死 脑溢血 胰岛素抵抗 胰岛素敏感性指数 

分 类 号：R743.33[医药卫生—神经病学与精神病学]