脑梗死患者胰岛素抵抗与血浆纤溶酶原激活物抑制物-1的关系  

The relationship between insulin resistance and plasminogen activa tor inhibitor type-1 in patients with cerebral infarction.

作　　者：肖伟忠[1] 裴世澄[2] 孙圣刚[1] 

机构地区：[1]华中科技大学同济医学院协和医院神经内科,湖北武汉430022 [2]兰州医学院第二附属医院神经内科,甘肃730030

出　　处：《中国综合临床》2003年第10期879-880,共2页Clinical Medicine of China

摘　　要：目的明确脑梗死患者存在胰岛素抵抗 (IR) ,探讨IR与血浆纤溶酶原激活物抑制物 1 (PAI 1 )的关系。方法选择62例脑梗死患者和 35例健康体检者。测定空腹血糖 (FBG)、空腹胰岛素 (FINS)浓度和血浆PAI 1活性。计算胰岛素敏感指数 (ISI) ,并与神经功能缺失评分、梗死灶面积和PAI 1进行直线相关分析。结果脑梗死患者FBG、FINS和PAI 1显著高于对照组 ;ISI显著低于对照组。脑梗死轻型组与脑梗死重型组之间FINS、ISI和PAI 1存在显著差异。ISI与梗死灶面积、神经功能评分和PAI 1呈负相关 ;PAI 1与梗死灶面积和神经功能缺失评分呈正相关。结论脑梗死患者存在胰岛素抵抗和纤溶活性的降低 ;IR和PAI 1与脑梗死患者病情轻重密切相关 ,IR和PAIObjective To demonstrate the presence of insulin resistance(IR ) in cerebral infarction(CI) and to explore the relationship between IR and seru m plasminogen activator inhibitor type-1(PAI-1) in patients with CI.Me thods The levels of fasting serum insulin(FINS),fasting blood-glucose(F BG) and PAI-1 were determined in 62 patients with CI and 35 healthy controls.Th e insulin sensitivity index(ISI) was calculated.The ISI and PAI-1 was analyzed by linear correlation with the score of neurological impairment and the size of lesion in patients with different grades of CI.Results The level s of FBG,FINS and PAI-1 of the patients with CI were significantly higher than those of the control group.ISI was significantly lower than that in control grou p.There was also significant difference in FINS,ISI and PAI-1 between the mild group and moderate-severe group with CI.ISI was negatively correlated with area of CI,PAI-1 and the score of neurological impairment but PAI -1 was positivel y correlated with area of CI and the score of neurological impairment.Co nclusion There is presence of IR and the decrease of PAI-1 in patients with CI.The IR and PAI-1 is closely correlated with severity.They may play an i mportant role in the development of CI.

关 键 词：脑梗死 胰岛素抵抗 纤溶酶原激活物抑制物-l 空腹血糖 空腹胰岛素 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R587[医药卫生—临床医学]