高血压病及伴脑腔隙性梗死患者胰岛素敏感性三项指标评价  

Using Oral Glucose Tolerance Test and Insulin Release Test to Compare Three Evaluation Indexes of Insulin Sensitivity in Essential Hypertensive patient with or without Lacunar Infarction

作　　者：郭冀珍[1] 龚艳春[1] 陶波[1] 孙首悦[1] 冯颖青[2] 林伯贤[1] 

机构地区：[1]上海第二医科大学附属瑞金医院高血压科,上海市高血压研究所上海200025 [2]广东省心血管研究所,广东510000

出　　处：《心脑血管病防治》2003年第6期5-7,共3页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：上海市医学发展基金重点研究项目(2 0 0 0 1-ZD0 0 1)

摘　　要：目的　评价高血压病及伴脑腔隙性梗死患者的胰岛素敏感性情况。方法　 ( 1) 30名正常人及 14 3例高血压病人 (内含 10 3例腔隙性脑梗死患者 )均做口服 75g葡萄糖耐量试验 ,并按脑磁共振显像 (MRI)结果分成三组 :正常人组、有脑腔隙性病变 [L( + ) ]组、无腔隙性病变 [L( - ) ]组。 ( 2 )比较计算胰岛素敏感性的三种方法 :1(FGP×Fins) ,OGTT及InRT的曲线下面积 (AUC)比值 :AUCOGTT/AUCInRT及用Cederholm函数公式计算的Ins敏感指数 :Cederholm -ISI。( 3)分析胰岛素抵抗是否为脑部小血管病的危险因素。结果　 ( 1) 1/ (FPG×FIns)、AUCOGTT/AUCInRT及Cederholm -ISI,三种方法计算Ins敏感性指数 ,三种方法之间两两相关 (r=0 30 6 ,r =0 534 ,r=0 54 7,P <0 0 1)。 ( 2 )Cederholm -ISI在高血压病脑腔隙性有、无梗塞二组中有明显差异 (P <0 0 5)。结论　 ( 1)比较计算胰岛素敏感性的三种方法发现用Cederholm -ISI方法比 1/ (FPG×FIns)及AUCOGTT/AUCInRT更敏感。 ( 2 )Objective To inv estigate the insulin sensitivity in hype rtensive patients with or without lacuna r infarction.Methods Study i ncluded 30 normal subjects (control grou p)and 143 hypertension patients.All subj ects were divided into three groups:cont rol group (n=30);according to the result s of MRI,143 hypertension patients were again divided into two subgroups:hyperte nsive patients with lacunar infarction ( n=103) and without lacunar infarction (n =40).All subjects condrcted oral glucose tolerance test (OGTT) and insulin relea se test (InRT).All data were compared wi th three different calculation methods:1 /(FPG×FIns),AUC OGTT /AUC InRT and Ce derholm-ISI.Then to analyse whether insu lin resistance is a risk factor in hyper tensive patients with lacunar infarction .Results (1)1/(FPG×FIns),AUC OGTT /AUC InRT and Cederholm-ISI had positive correlation with each other (r =0 306,r=0 534,r=0 547, P <0 01,respectively).( 2)The significant difference of cederhol m-ISI was observed in hypertensive patie nts with and without lacunar infarction ( P <0 05).Conclusions (1)Ceder holm-ISI seems more sensitive than 1/(FP G×FIns) and AUC OGTT /AUC InRT to eva luate the insulin-sensitivity in hyperten sive patients.(2)Insulin resistance may be the risk factor of cerebral microvasc ular disease.

关 键 词：高血压病 脑腔隙性梗死 胰岛素抵抗 IR 糖耐量 

分 类 号：R544.1[医药卫生—心血管疾病] R743.33[医药卫生—内科学]