脑梗死患者胰岛素抵抗与脑血流动力学的相关性分析

目的分析脑梗死患者胰岛素抵抗的情况及其与脑血流动力学变化的相关性。方法临床确诊114例脑梗死患者和94例健康体检者进行经颅多普勒(TCD)检测,观察颅内血管血流动力学变化情况,同时检测空腹血糖和空腹胰岛素水平。结果 (1)脑梗死组患者胰岛素抵抗显著高于对照组(P<0.01);(2)脑梗死组脑血管血流速度异常率、搏动指数(PI)均显著高于对照组(P<0.01);(3)梗死-胰岛素抵抗组的血流速度异常率显著高于对照组、梗死-非胰岛素抵抗组(P<0.01),梗死-非胰岛素抵抗组与对照组无统计学差异(P>0.05)。梗死-胰岛素抵抗组的动脉PI值显著高于对照组、梗死-非胰岛素抵抗组(P<0.01),梗死-非胰岛素抵抗组与对照组无统计学差异(P>0.05)。(4)梗死组中,胰岛素抵抗与血流速度降低呈负相关(r=-9.19,P<0.05);与血流速度增高呈正相关(r=0.806,P<0.05);与正常血流速度无相关(r=-0.063,P>0.05);与搏动指数呈正相关(r=0.974,P<0.01)。结论 TCD可以对存在胰岛素抵抗的患者脑血管状态提供客观的信息。联合检查患者胰岛素抵抗和TCD对于脑梗死的临床诊断、治疗、预防评估起到重要作用,可作为脑梗死早期诊断的依据之一。

Analysis of the correlation between insulin resistance and cerebral blood flow dynamics in patients with cerebral infarction

Objective To analysis insulin resistance in patients with cerebral infarction and its correlation with cerebral hemodynamic changes. Methods 114 cases of cerebral infarction patients and 94 cases of healthy physical examination were detected by transcranial Doppler （TCD）, observed intracranial vascular hemodynamic changes, detected the levels of fasting plasma glucose and fasting insulin at the same time. Results （1） Insulin resistance in patients with cerebral infarction group was significantly higher than that of control group （P〈0.01）. （2） The rate of cerebral infarction group of cerebral blood flow velocity anomaly, pulsatility index （PI） were significantly higher than that of control group （P〈0.01）. （3） Infarction group with insulin resistance of blood flow velocity abnormality rate was significantly higher than the control group, the infarction without insulin resistance group （P〈0.01）. The infarction without insulin resistance group and control group had no significant difference （P〉0.05）. Infarction group with insulin resistance of artery PI of value was significantly higher than the control group, infarction without insulin resistance group （P〈0.01）. Infarction without insulin resistance group and the control group had no statistical difference （P〉0.05）. （4） Insulin resistance and blood flow velocity of low were negative correlation （P〈0.05） and insulin resistance and blood flow velocity of increase were positive correlation in infarction group （P〈0.05）, but insulin resistance and blood flow velocity of normal had no correlation （P〉0.05）. Conclusion TCD can help patients with cerebral infarction and insulin resistance to provide objective information. Insulin resistance and TCD joint inspection patients that play an important role in clinical. It can be taken as the basis for early diagnosis of cerebral infarction.