氯氮平血药浓度和用药剂量、临床疗效及不良反应关系的研究

目的:通过研究确定氯氮平血药浓度和用药剂量、临床疗效及不良反应之间的关系,确定其有效血药浓度范围。方法:通过对98例服用氯氮平治疗精神分裂症患者进行研究,利用HPLC法测定其血药浓度,用BPRS量表和TESS量表分别评价其临床疗效和药物不良作用,并对患者血药浓度与用药剂量、临床疗效及不良反应之间的相关性进行统计学分析。结果:(1)氯氮平血药浓度和临床用药剂量之间呈显著正相关(r=0.853,P<0.01,n=98)。(2)血药浓度与临床疗效之间呈显著正相关(r=0.512,P<0.01,n=98)。(3)血药浓度与不良反应之间呈显著正相关(r=0.689,P<0.01,n=98)。结论:氯氮平血药浓度和用药剂量、临床疗效及不良反应之间呈显著相关。推荐氯氮平临床治疗血药浓度适宜范围为200~550μg.L-1,氯氮平的血药浓度监测对指导个体化合理用药具有临床意义。     

氯氮平治疗女性不同病程精神分裂症患者血清IL-6及sIL-6R的变化

目的探讨女性精神分裂症患者血清白细胞介素-6、可溶性白细胞介素-6受体治疗前后变化及其与抗精神病药物氯氮平血清浓度的关系.方法采用酶联免疫吸附法测定40例女性精神分裂症患者治疗前及治疗后第1周、第2周、第4周血清IL-6和sIL-6R浓度,同时用高效液相色谱法测定氯氮平浓度,以20例女性健康者血清IL-6、slL-6R浓度作对照.治疗前与治疗后第28天评定阴阳性症状量表(PANSS)各一次.结果(I)病程≤5年组患者治疗前血清IL-6和sIL-6R浓度均显著高于正常对照组(P＜0.01);治疗后第1、2、4周血清IL-6和sIL-6R浓度均显著低于对照组(P＜0.01);(2)病程＞5年组患者治疗前及治疗后第1、2、4周血清IL-6、sIL-6R浓度均显著低于正常对照组(P＜0.01):(3)除病程＞5年组患者第1周血清IL-6浓度与氯氮平浓度呈负相关(p＜0.01)外,余各时点血清sIL-6R浓度与氯氮平浓度均无显著相关性(P＞0.05);(4)氯氮治疗4周后,PANSS减分率与IL-6、sIL-6R减分率无显著相关(P＞0.05).结论女性精神分裂症患者血清IL-6、sIL-6R水平与健康女性差异显著,氯氮平对IL-6和SIL-6R有抑制作用,氯氮平的抗精神病作用可能与对IL-6、sIL-6R的调节作用有关.     

氯氦平血药浓度和用药剂量、临床疗效及不良反应关系的研究

目的通过研究确定氯氮平血药浓度和用药剂量、临床疗效及不良反应之间的关系,确定其有效血药浓度范围.方法通过对98例服用氯氮平治疗精神分裂症患者进行研究,利用HPLC法测定其血药浓度,用BPRS量表和TESS量表分别评价其临床疗效和药物不良作用,并对患者血药浓度与用药剂量、临床疗效及不良反应之间的相关性进行统计学分析.结果(1)氯氮平血药浓度和临床用药剂量之间呈显著正相关(r=0.853,P＜0.01,n=98).(2)血药浓度与临床疗效之间呈显著正相关(r=0.512,P＜0.01,n=98).(3)血药浓度与不良反应之间呈显著正相关(r=0.689,P＜0.01,n=98).结论氯氮平血药浓度和用药剂量、临床疗效及不良反应之间呈显著相关.推荐氯氮平临床治疗血药浓度适宜范围为200～550 μg·L-1,氯氮平的血药浓度监测对指导个体化合理用药具有临床意义.     

血清尿酸水平与冠状动脉病变程度的关系

目的:探讨冠状动脉造影患者血清尿酸(SUA)水平与冠状动脉病变程度的关系.方法:入选我院行冠状动脉造影(CAG)患者474例,根据CAG结果分为冠心病(CAD)组(366例)和非CAD组(108例).冠状动脉病变程度采用冠状动脉病变支数和冠状动脉病变Gensini积分(GS)量化.结果:(1)总体CAD组SUA水平高于非CAD组(P<0.05),亚组分析女性CAD组SUA水平高于女性非CAD组(P<0.05);总体CAD组、男性CAD组、女性CAD组高尿酸(HUA)百分比均高于非CAD组(P<0.05).(2)SUA水平第3、第4四分位的CAD患病率明显高于第1、第2四分位(P<0.05).(3)多因素Logistic回归分析显示HUA是经CAG诊断的CAD的危险因素(OR=2.639,95%CI为1.080～6.443,P=0.033).(4)相关分析提示SUA水平和GS有正相关性(r=0.270,P<0.01),亚组分析男性、女性SUA水平和GS间均有正相关性(r=0.171,P<0.01;r=0.298,P<0.01).结论:SUA可能是CAG诊断的CAD的危险因素.SUA水平和冠状动脉病变程度有一定相关性,女性相关性较男性略显著.     

鱼腥草注射液不良反应文献的数据挖掘研究

目的探讨鱼腥草注射液不良反应的流行病学特点。方法通过检索1978～2006年医药学期刊,收集165例鱼腥草注射液不良反应文献报告,构建数据库并应用统计学和数据挖掘方法对信息进行分析。结果女性患者的平均年龄显著高于男性患者(P<0.05)";中青年"患者群中过敏性休克的构成比显著高于"未成年与老年"患者群(P<0.01),而皮肤损害的构成比显著低于"未成年与老年"患者群(P<0.05);17岁以上患者群中过敏性休克的构成比显著高于17岁以下患者群(P<0.01),而皮肤损害的构成比显著低于17岁以下患者群(P<0.01)。结论应规范合理用药,增强预防意识,减少鱼腥草注射液不良反应的发生。     

哮喘大鼠血管内皮生长因子表达与γ-干扰素、白介素-4变化的相关性及地塞米松的干预

目的:观察血管内皮生长因子(vascular endothelial growthfactor,VEGF)、γ-干扰素(IFN-γ)、白介素-4(IL-4)在大鼠哮喘急性模型中的表达情况,探讨Th细胞亚群的失衡与其表达的相关性.方法:36只清洁级雄性sD大鼠随机分为生理盐水对照组(C组)、哮喘组(A组)和地塞米松干预组(D组),以卵清白蛋白(ovalbumin,OVA)致敏激发法制备大鼠哮喘急性模型.末次激发24 h后腹腔注射麻醉,心脏取血,右肺行支气管肺泡灌洗留取灌洗液(BALD.应用酶联免疫吸附(ELISA)法测定血清和BALF中IL-4、IFN-γ和VEGF的浓度.结果:A组血清和BALF中IL-4、VEGF的水平均分别显著高于C组,D组血清和BALF中IL-4、VEGF的水平均分别显著低于A组(P<0.01),C组和D组相比差异均无统计学意义(P>0.05).A组血清和BALF中IFN.,的水平均显著低于C组(P<0.01),D组血清、BALF中的IFN-γ水平均显著高于A组(P<0.01)而低于C组(P<0.01).大鼠BALF中IL-4浓度与VEGF浓度呈显著正相关(r=0.797,P<0.01),IFN-γ浓度与VEGF浓度呈显著负相关(r=-0.568,P相似文献   

氯氮平与齐拉西酮对老年痴呆精神行为障碍患者认知及脂代谢的影响

目的对比分析氯氮平与齐拉西酮对老年痴呆精神行为障碍患者认知及脂代谢的影响。方法选取2014年2月至2016年9月我院收治的老年痴呆精神行为障碍患者108例,根据治疗方式的不同将其分为氯氮平组与齐拉西酮组,每组54例,两组均连续治疗8周。评估并比较两组临床疗效,采用简易智能精神状态检查量表(MMSE)和蒙特利尔认知功能量表(MoCA)评价并比较两组患者治疗前后认知能力变化,检测并比较两组患者治疗前后血脂代谢指标的变化;采用药物不良反应量表(TESS)比较两组患者治疗期间不良反应发生情况。结果治疗后,齐拉西酮组有效率(94.44%)显著高于氯氮平组(77.78%)(P<0.05);两组患者MMSE评分与MoCA评分与治疗前相比均升高(P<0.01),且齐拉西酮组高于氯氮平组(P<0.01);齐拉西酮组患者血清TC、TG、LDL、HDL水平及BMI与治疗前比较差异无统计学意义(P>0.05),氯氮平组患者血清TC、TG、LDL水平及BMI高于治疗前及齐拉西酮组(P<0.05或P<0.01),HDL水平较治疗前降低,且低于齐拉西酮组(P<0.05或P<0.01);齐拉西酮组患者TESS评分为(3.62±1.25)分,低于氯氮平组的(5.85±2.31)分(P<0.01)。结论齐拉西酮治疗老年痴呆精神行为障碍的疗效优于氯氮平,同时可显著增强患者认知能力,对脂代谢的影响较小且不良反应较少。     

血清脂肪因子CXCL5水平与肥胖和胰岛素抵抗的相关性

目的 探讨脂肪因子CXCL5与肥胖、胰岛素抵抗的相关性.方法 将86例血糖调节正常者按体重指数(BMI)分为男性超重或肥胖组(A组,26例,BMI≥25)、女性超重或肥胖组(B组,17例,BMI≥25)、男性正常体重组(C组,23例,BM<25)和女性正常体重组(D组,20例,BMI<25).ELISA法测定血清CXCL5水平.结果 D组血清CXCL5水平明显高于C组(P<0.01);B组血清CXCL5水平显著高于A组(P<0.01);A组血清CXCL5水平显著高于C组(P<0.05).男性血清CXCL5水平与BMI、腰围(WC)、腰臀比(WHR)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)呈正相关(P<0.05),与胰岛素抵抗指数(HOMA-IR)无明显相关性.多元线性回归提示WC、LDL-C是男性组血清CXCL5水平的独立影响因素.结论 CXCL5可能参与肥胖和脂代谢紊乱病理生理过程.     

运用重复一点法研究氯氮平个体化给药方案

目的研究氯氮平的个体化给药方案.方法60名精神分裂症患者随机分成实验组和对照组,实验组服用重复一点法计算的氯氮平剂量,对照组服用6 mg*kg-1固定剂量,于2,4,6,8周末用简明精神科量表(BPRS)和不良反应量表(TESS)评定临床疗效和不良反应,并测定各周稳态氯氮平和去甲氯氮平浓度.结果实验组与对照组所用剂量统计学上无显著性差异(P＞0.05),但男性实验组与对照组剂量差异有显著性(P＜0.05),两组BPRS减分值和有效率差异无显著性(P＞0.05).两组各周TESS增分值差异有显著性(P＜0.05),BPRS减分值与氯氮平浓度、氯氮平和去甲氯氮平浓度之和未发现显著性相关(P＞0.05),TESS增分值与氯氮平浓度、氯氮平和去甲氯氮平浓度之和显著相关(P＜0.01).结论重复一点法用于氯氮平的个体化给药有一定的实用价值.     

104例不同民族肾病综合征患者他克莫司血药浓度的影响因素分析

目的:探究不同民族肾病综合征(NS)患者中他克莫司(TAC)血药浓度的影响因素。方法:采用回顾性研究方法,收集2017年12月-2018年11月在新疆医科大学第一附属医院确诊为NS并符合纳入/排除标准的104例患者的临床信息,包括性别、年龄、民族、身高、体质量、实验室相关检测、合并用药及TAC给药剂量等,通过SPSS 22.0软件分析TAC血药浓度的影响因素,以及合用五酯胶囊对TAC稳态血药谷浓度(c_(min)~(ss))和剂量的影响。结果:104例患者,共计394例次TAC血药浓度监测。以TAC标准化血药浓度为终点指标,汉族患者显著低于维吾尔族和哈萨克族患者(P=0.003);合用五酯胶囊患者高于不合用患者(P=0.056);合用钙离子拮抗药患者显著高于不合用患者(P=0.01),合用质子泵抑制剂患者显著低于不合用患者(P=0.01);红细胞比容正常患者显著低于异常患者(P=0.001),尿素氮正常患者显著低于异常患者(P<0.001)。合用五酯胶囊患者的TAC剂量显著低于不合用患者(P=0.001),二者TAC的c_(min)~(ss)无明显差异(P=0.29)。结论:对于NS患者,在使用TAC时应考虑民族、钙离子拮抗药、质子泵抑制剂、红细胞比容、尿素氮及五酯胶囊对TAC血药浓度的影响。     

CYP1A2 activity is an important determinant of clozapine dosage in schizophrenic patients

Clozapine is an effective atypical antipsychotic drug applied in the treatment of resistant schizophrenia. The drug is mainly metabolized by cytochrome P-450 (CYP) enzymes especially the isozyme CYP1A2. Remarkably, the effective dosage varies widely among patients, making it necessary to individualize drug therapy with clozapine. The explanation for dosage variation may be differences in drug metabolism, and more specifically of CYP1A2 activity. This study is aimed at determining to what extent variability in clozapine dose can be explained by pharmacokinetic (PK) factors and more specifically by CYP1A2 activity in effectively treated psychiatric patients.

In 22 evaluable patients with a schizophrenic disorder chronically using clozapine, the CYP1A2 activity and the clozapine clearance were estimated. For calculation of the pharmacokinetic parameters of clozapine, population PK software based upon Bayesian analysis was used. Caffeine clearance was estimated with the paraxanthine/caffeine ratio and served as estimate of CYP1A2 activity.

A significant linear relationship was found between the clozapine dose and clozapine clearance (R: 0.71; P<0.05), whereas no relationship was found between clozapine dosage and clozapine serum trough concentration. Moreover, individual caffeine and clozapine clearances were found to be significantly related (R: 0.62; P<0.05) as were clozapine dose per kg body weight and P/C mol ratio (R: 0.44; P<0.05).

We conclude that CYP1A2 activity is an important determinant of the variability of effective clozapine doses in psychiatric patients.     

精神分裂症氯氮平剂量与血药浓度相关分析

目的：精神分裂症氯氮平服药剂量与血药浓度的相关分析。方法：６１５人次确诊为精神分裂症氯氮平治疗患者，按给药量分组，与氯氮平及其去甲基氯氮平的血药浓度进行回顾性统计分析。结果：氯氮平剂量与浓度作曲线成四个线段；各线段内给药量与血药浓度的相关系数远大于整体相关系数。结论：曲线说明其血药浓度与给药剂量虽然呈正相关，但各个线段有着更深刻的意义。氯氮平与去甲基氯氮平血药浓度稳态时，晚服药后次日晨分别不宜超过３５０ｎｇ，２００ｎｇ。     

An inter-ethnic comparison study of clozapine dosage, clinical response and plasma levels

The present study investigated clozapine dosage, plasma clozapine and metabolite levels, clinical and side-effect profiles in Asian versus Caucasian patients with chronic schizophrenia who were on stable maintenance treatment. Twenty Asian patients from Singapore and 20 Caucasian patients from Australia were systematically evaluated with the following rating scales: Positive and Negative Syndrome Scale for Schizophrenia, drug attitude scale (DAI-10), drug adverse reaction profile (Liverpool University Neuroleptic Side-effect Rating Scale), extrapyramidal side-effects scales (Abnormal Involuntary Movement Scale, Simpson and Angus Scale). Cigarette and caffeine consumption were recorded and steady-state plasma clozapine and metabolites levels were measured. Although Asian patients received a significantly lower mean clozapine dose (176 mg/day) than the Caucasian group (433 mg/day, P<0.001), plasma clozapine levels were similar between the groups. As a result, Asian patients had more than twice the effective clozapine concentration to dose ratio (P<0.001). The findings remained significant even after controlling for gender, body mass index, cigarette, alcohol and caffeine use. Conversely, the plasma metabolites (desmethylclozapine and clozapine N-oxide) to clozapine ratios were higher in the Caucasian patients (P<0.01). Compared to Caucasian patients, Asian patients appeared to have a lower dosage requirement for clinical efficacy. Hence, appropriate dose adjustment should be considered in Asian patients receiving maintenance clozapine therapy in clinical practice.     

外周血高迁移率族蛋白-1和NF-κB在肾病综合征中的作用

目的分析原发性肾病综合征患者血清中HMGB-1、NF-κB的关系,探讨其在原发性肾病综合征中的作用。方法2014年1月至2015年7月我院40例原发性肾病综合征患者为观察组,同时纳入40例健康体检者为对照组。采用ELISA法测定外周血清中HMGB-1、NF-κB的浓度,同时收集受试者尿蛋白、血脂等相关临床资料。评价尿蛋白定量、TG、TC、HDL-C、LDL-C水平、血清白蛋白水平、C-反应蛋白水平及血清HMGB-1、NF-κB水平。采用Pearson相关性分析进行变量之间的统计学分析。结果观察组HMGB-1和NF-κB的浓度均高于对照组,差异有统计学意义(P<0.01)。Pearson相关分析结果显示,HMGB-1与尿蛋白定量(r=0.74,P<0.01)、TG(r=0.33,P<0.01)、TC(r=0.52,P<0.01)、LDL-C(r=0.26,P<0.01)、CRP(r=0.41,P<0.01)呈正相关,与白蛋白(r=-0.56,P<0.01)呈负相关。NF-κB与尿蛋白定量(r=0.62,P<0.01)、TG(r=0.28,P<0.01)、TC(r=0.43,P<0.01)、LDL-C(r=0.29,P<0.01)呈正相关,与白蛋白(r=-0.45,P<0.01)呈负相关。HMGB-1与NF-κB呈正相关,相关系数为0.84,差异有统计学意义(P<0.01)。结论原发性肾病综合征患者血清中HMGB-1、NF-κB水平均升高,两者呈正相关。HMGB-1在肾病综合征的发病中可能通过NF-κB起作用。     

Influence of dose, cigarette smoking, age, sex, and metabolic activity on plasma clozapine concentrations: a predictive model and nomograms to aid clozapine dose adjustment and to assess compliance in individual patients

The measurement of plasma clozapine concentrations is useful in assessing compliance, optimizing therapy, and minimizing toxicity.We measured plasma clozapine and norclozapine (N-desmethylclozapine) concentrations in samples from 3782 patients (2648 male, 1127 female). No clozapine was detected in 291 samples (227 patients, median prescribed dose 300 mg/d). In 4963 (50.2 %) samples (2222 patients); plasma clozapine concentration ranged from 10 to 350 ng/mL.Step-wise backward multiple regression analysis (37 % of the total samples) of log10 plasma clozapine concentration against log10 clozapine dose (mg/d), age (year), sex (male = 0, female = 1), cigarette smoking habit (nonsmokers = 0; smokers = 1), body weight (kg), and plasma clozapine/norclozapine ratio (clozapine metabolic ratio, MR) showed that these covariates explained 48% of the observed variation in plasma clozapine concentration (C = ng/mL x 10-3) (P < 0.001) according to the following equation: log 10 (C) = 0.811 log 10 (dose) + 0.332 (MR) + 69.42 X 10 (-3) (sex) + 2.263 x 10 (-3) (age) + 1.976 x 10(-3) (weight) - 0.171 (smoking habit) - 3.180. This model and its associated confidence intervals were used to develop nomograms of plasma clozapine concentration versus dose for male and female smokers and nonsmokers. Predicted plasma clozapine changes by +48% in nonsmokers, +17% in females, +/-8 % for every 0.1 change in MR (reference 1.32), +/-4% for every 5 years (reference 40 years), and +/-5 % for every 10 kg body weight (reference 80 kg). The nomograms can be used (i) to individualize dosage to achieve a given target plasma clozapine concentration, and (ii) for quantitative evaluation of adherence by estimating the likelihood of an observed concentration being achieved by a given dosage regimen. The model has been validated against published data.     

高血压患者血清胰岛素,甲状旁腺激素及降钙素的测定和意义

测定２８例原发性高血压病（ＥＨ）患者和１５例健康对照血清钙,甲状旁腺激素（ＰＴＨ）,降钙素（ＣＴ）,计算ＰＴＨ／ＣＴ比值,空腹葡萄糖（ＳＧ）,胰岛素（ＩＳ）和Ｉ／Ｇ比值,结果：ＥＨ组ＰＴＨ,ＰＴＨ／ＣＴ,ＩＳ和Ｉ／Ｇ高于对照组（均Ｐ〈０．０１）,血清钙和ＣＴ低于对照组（Ｐ〈０．０５,Ｐ〈０．０１）,单因子相关分析表明平均动脉压（ＭＡＰ）和ＰＴＨ,ＰＴＨ／ＣＴ,ＩＳ和Ｉ／Ｇ呈正相关,与血清钙,矣呈负     

枸橼酸钠与阿加曲班在危重患者连续性静脉-静脉血液滤过治疗中的抗凝效果比较

目的：对比枸橼酸钠和阿加曲班在危重患者连续性静脉-静脉血液滤过( CVVH)治疗中的抗凝效果和安全性,优化危重症患者连续性血液净化的抗凝方案。方法广州医科大学附属第三医院2014年6月—2015年5月收治危重患者共134例,按随机抽样原则分为枸橼酸钠组59例、阿加曲班组75例,记录并对比两组的一般情况、CVVH治疗时间、凝血功能、血常规和生化检查等项目。结果阿加曲班用量与APACHEⅡ评分呈负相关。阿加曲班组治疗前、后凝血酶原时间( PT)、活化部分凝血活酶时间( APTT)、国际标准化比值( INR)、纤维蛋白原( Fb)比较差异有统计学意义(P<0．01),治疗后PT、APTT和INR与枸橼酸钠组比较差异亦有统计学意义(P<0．05,P<0．01)。两组均未并发出血不良事件。两组治疗前、后 pH值均在正常值范围内,阿加曲班组治疗后 pH 值显著高于治疗前(P<0．05);两组治疗前、后白细胞、红细胞压积(HCT)、血肌酐、血钠和血钾比较差异均无统计学意义(P>0．05)。枸橼酸钠组CVVH治疗开始时、结束前滤器后血钙与体内血钙比较差异均有统计学意义(P<0．01);阿加曲班组与枸橼酸钠组相同时点滤器后血钙比较差异亦有统计学意义(P<0．01)。结论枸橼酸钠和阿加曲班在危重症患者CVVH治疗中的应用均安全有效。枸橼酸钠更适合应用于有出血风险的危重症患者;阿加曲班在肾功能不全的患者中仍能安全使用,且代谢迅速、易于监测,亦为危重患者CVVH治疗中抗凝药物的较佳选择。     

甘油三酯,血糖与心脑血管病的关系

对１４６例冠心病，原发性高血压和脑血管病病人的血清甘油三酯和血糖进行检测。结果发现；１．在该组病人在ＴＧ与ＢＧ呈显著正相关。２．血清ＴＧ和ＢＧ水平与体重指数亦呈正相关。３．ＴＧ与ＢＧ对３种疾病的患病率有明显影响，测定值升高者均比正常值者患病率高，且差异有统计学意义。     

Therapeutic drug monitoring data: risperidone does not increase serum clozapine concentration

BACKGROUND: Two case reports suggest that serum clozapine concentration may increase when risperidone is added to clozapine treatment. However, risperidone is not a significant inhibitor of the most important clozapine metabolising cytochrome P(450) (CYP) enzymes (e.g. CYP1A2). OBJECTIVE: To study whether serum clozapine concentrations are affected by risperidone. METHODS: Intraindividual comparison of serum clozapine therapeutic drug monitoring data from 18 patients during and without risperidone use. RESULTS: Addition of risperidone (mean +/-SD dose 2.9+/-0.9 mg/day, range 2-4 mg/day) to clozapine treatment (mean clozapine dose 451+/-207 mg/day) did not result in any significant changes in serum clozapine concentration or clozapine concentration/dose (C/D) ratio relative to the values without risperidone (mean clozapine dose 437+/-168 mg/day). During risperidone use mean serum clozapine concentration was 3% (P=0.75) and C/D ratio 8% (P=0.46) lower than without concomitant risperidone. The mean ratio mu(test)/mu(reference) for clozapine C/D ratios was 0.99 (90% CI 0.82-1.15), confidence interval being within the equivalence interval of 0.80-1.25. CONCLUSIONS: Risperidone does not affect serum clozapine concentrations to any significant degree.     

糖耐量减低患者血清瘦素水平与肥胖、血糖及胰岛素的相关性研究

目的　探讨糖耐量减低 (IGT)患者血清瘦素水平与肥胖程度、血糖、胰岛素浓度的关系。方法　测定 6 0例IGT患者的空腹血清瘦素水平 ,并行口服葡萄糖耐量试验 ,测定血浆胰岛素和葡萄糖浓度 ,同时测定身高、体重 ,计算体重指数 (BMI)。结果　血清瘦素水平与BMI呈正相关 (男r=0 6 39,P <0 0 1;女r =0 76 2 ,P <0 0 1) ,女性显著高于男性 (P <0 0 1)。采用多元逐步回归法分析 ,去除BMI等因素的影响后 ,瘦素与胰岛素曲线下面积呈正相关 ,与血糖浓度无相关性。结论　肥胖者空腹血清瘦素升高 ,高瘦素血症与高胰岛素血症的相关性提示 ,瘦素可能在IGT发展成 2型糖尿病 (2型DM )中亦起一定的作用