脑出血患者胰岛素抵抗现象的临床观察

目的 探讨高血压性脑出血（HIH）患者是否存在胰岛素抵抗（IR）与高胰岛素血症（HIS）,以及IR与患者病情和预后的关系。方法 采用胰岛素敏感性指数（ISI）方法测定56例高血压性脑出血患者、37例原发性高血压患者血糖（FPG）和血清胰岛素水平（FINS）,并与49例健康人进行对照;3个月后对存活的高血压性脑出血患者进行随访并进行日常生活能力（ADL）Barthel指数评分。结果 高血压性脑出血患者血糖及血清胰岛素均明显高于对照组（P<0.01）,ISI较对照组明显减低（P<0.001）。高血压性脑出血患者轻型组与重型组的血糖、血清胰岛素、ISI也存在显著性差异（P<0.001,P<0.05,P<0.001）。随访高血压性脑出血患者ADL评分轻型组明显高于重型组。结论 高血压性脑出血患者存在IR及高胰岛素血症,其胰岛素水平及IR程度与患者病情和预后有关。

Clinical study on insulin resistance in patients with intracerebral hemorrhage

Objective To explore whether there would be insulin resistance(IR) and hyperinsulinemia( HIS) in the patients with hypertensive intracerebral hemorrhage (HIH) ,and the relationship of IR with the patients' conditions and prognosis. Methods The insulin sensitivity index(ISI) was adopted to determine fasting plasma glucose(FPG) and fasting serum insulin level(FINS) in 56 patients with hypertensive intracerebral hemorrhage and in 37 patients with primary hypertension. 49 normals were selected as controls. All the patients were followed up for three months. And We evaluated the Barthel index(BI) from activities of daily living scale (ADL) for the survivors. Results The study showed that FPG and FINS in the patients with intracerebral hemorrhage were much higher than those of the control group as well as than those in the group of primary hypertension with significant differences ( P <0. 001) ,while ISI in the group of intracerebral hemorrhage was significantly lower than in the control groups (P <0. 001). There were significant differences in FPG, FINS and ISI between the mild and severe subgroups of HIH ( P < 0. 01, P < 0. 05 , P < 0. 001). Moreover, ADL in the mild subgroup was significantly higher than that of the severe one. Conclusions There were IR and HIS in the patients with HIH and a postitive correlation was found between ISI and patients conditions, and prognosis.