胰岛素抵抗与脑卒中关系的临床研究

目的　探讨胰岛素抵抗 (IR)与脑卒中的关系。方法　 94例脑卒中患者分为动脉粥样硬化血栓性脑梗死组 (ATI,34例 ) ,腔隙性脑梗死组 (LI,2 5例 ) ,脑出血组 (ICH,35例 ) ;测定其空腹血糖 (FPG)和餐前、餐后C 肽及胰岛素浓度 ,计算其胰岛素敏感性指数 (ISI) ,并与对照组对比研究。结果　ATI组及LAC组的ISI显著低于对照组 (P<0 0 5 ) ,ICH组的ISI与对照组无显著性差异 (P >0 0 5 )。脑卒中的IR主要见于肥胖或甘油三脂 (TG)、低密度脂蛋白胆固醇 (LDL C)、尿酸 (UA)、载脂蛋白B(APO B)、高密度脂蛋白 (HDL)等生化指标中有三项以上异常的患者 (占39 4 % )。结论　IR与脑卒中有密切关系 ,提示通过饮食、运动、药物等方法在大宗人群进行降低IR的早期干预 ,不仅对现代常见代谢病 ,而且对脑卒中会有积极的预防作用。

A clinical study on the relationship between insulin resistance and stroke.

Objective To study the relationship between insulin resistance(IR) and stroke. Methods 94 patients with stroke were divided into artherothrombotic infarction (ATI) group (34 cases), lacunar infarction(LI) group (25 cases) and intracerebral hemorrhage(ICH) group(35 cases). Their fasting plasma glucoses, serum C Ps, insulin levels before and two hours after breakfast were measured. Their insulin sensitivity indexes (ISI) were compared with those of normal control group (18 cases). Results ISIs of ATI and LI group were significantly lower than those of normal control group ( P<0.05 ). No signifcant differences were found between the ICH and normal control group ( P>0 05 ). Stroke patients with IR were usually obese or had abnormalities of more than three lipid biochemistry indices (39 4%). Conclusions There was an strong relationship between IR and stroke. Early intervention to decrease IR through diet, sports and medicines in community population would be beneficial to the prevention of stroke, as well as modern metaboic disease.