肺心病患者胰岛素抵抗的临床研究

目的观察肺心病急性期患者空腹血清胰岛素、空腹血糖、胰岛素敏感指数水平变化,探讨肺心病患者是否存在胰岛素抵抗。方法选择2006年11月至2008年12月在我院住院的31例肺心病急性期患者作为实验组,选择同期健康体检31例作为对照组。2组临床基线资料匹配。所有选定的参选者均测定空腹血糖(FBG)、FINS及胰岛素敏感指数(ISI)。FBG采用葡萄糖氧化法测定,FINS采用酶联免疫吸附法测定,ISI采用李光伟等提出的计算方法进行计算。结果实验组FINS水平明显高于对照组〔(16.63±8.74〕vs(6.08±2.53)μIU/ml,P<0.01〕,FBG水平显著高于对照组〔(6.48±2.33)vs(4.79±0.75)mmol/L,P<0.01〕,ISI显著低于对照组〔(-4.26±0.92)vs(-3.26±0.51),P<0.01〕。结论肺心病急性期患者存在胰岛素抵抗,胰岛素抵抗为其重要的危险因素,这为肺心病患者使用胰岛素增敏剂治疗提供了科学依据。

Clinical study of insulin resistance in patients with pulmonary heart disease

Objective To observe the levels of fasting serum insulin(FINS),fasting blood glucose(FBG) and insulin sensitivity index(ISI)of patients with pulmonary heart disease in acute period,and investigate whether the insulin resistance(IR) exists in patients with pulmonary heart disease.Methods Thirty-one patients with pulmonary heart disease in acute period admitted in our hospital from November 2006 to December 2008 were selected as experimental group,and 31 healthy subjects were selected as control group.The clinical basic data were matched in the two groups.FBG,FINS and ISI were measured in all the eligible participants.FBG was measured by glucose oxidation method;FINS was detected by enzyme-linked immunosorbent assay;ISI was calculated using the formula proposed by Liguangwei,etc.Results FINS level in experimental group was higher than that in control group 〔(16.63±8.74) vs(6.08±2.53)μIU/ml,P<0.01〕.FBG level in experimental group was higher than that in control group 〔(6.48±2.33) vs(4.79±0.75) mmol/L,P<0.01〕.ISI in experimental group was lower than that in control group 〔(-4.26±0.92) vs(-3.26±0.51,P<0.01〕.Conclusions The IR exists in patients with pulmonary heart disease in acute period,which becomes an important risk factor of pulmonary heart disease,and thus provides a scientific basis for the use of insulin sensitizers in the treatment of patients with pulmonary heart disease.