冠心病合并高胰岛素血症患者血浆内皮素与冠脉病变关系的研究

目的：研究冠心病合并高胰岛素血症（hyperinsulinmia，HIS）患者血浆内皮素（endothelins，ET）水平与冠状动脉病变程度的关系。方法：选择91例冠心病患者，依临床资料分为3组：Ⅰ组（n=29）：单纯冠心病组；Ⅱ组（n=30）：冠心病合并IGT组；Ⅲ组（n=32）：冠心病合并T2DM组，均采用放射免疫法测定血清空腹胰岛素（INS），酶联免疫吸附法（ELISA）测定血浆ET活性。根据冠脉造影（CAG）结果，采用冠脉狭窄程度积分（coronary narrow degreeintegral）评价冠脉病变程度。结果：冠心病合并2型糖尿病组的血浆ET、INS及冠脉狭窄程度积分均较单纯冠心病组升高（P〈0．01）较冠心病合并糖耐量异常组升高（P〈0．05）；冠心病合并糖耐量异常组明显高于单纯冠心病组（P〈0．05）；在冠心病合并高胰岛素血症患者中，血浆ET水平与血清INS水平及冠脉狭窄程度积分呈正相关。结论：冠心病合并高胰岛素血症患者ET水平明显升高；血浆ET水平与血清INS水平及冠脉狭窄程度相关。

Relationship among the level of ET and extent of coronary lesions in CHD Patients accompanied with HIS

Objective：To study the relationship between the level of ET and the extent of coronary lesions in CHD patients accompanied with HIS. Methods：Ninety-one CHD patients were included in the study： Group Ⅰ （n=29）,simple CHD;Group Ⅱ （n=30）,CHD accompanied with IGT; Group Ⅲ （n=32）,CHD accompanied withT2DM.The levels of serum INS and plasma ET of all the patients were measured by radioimmuno assay and ELISA respectively.The extent of coronary lesions was analyzed by total amountin tegral method. Results：The levels of serum INS,plasma ET and coronary artery narrow degree in GroupⅢ were significantly higher than Group Ⅰ ,and those of Group Ⅱ were significantly higher than Group Ⅰ .The levels of ET and INS were positively correlated with the coronary artery narrow degree in CHD patients accompanied with HIS. Conclusion： The levels of ET and INS are positively correlated with coronary artery narrow degree in CHD patients accompanied with HIS.