胰岛素抵抗与脑卒中关系的临床研究

目的：观察胰岛素抵抗与脑卒中的关系。方法：脑卒中组67例，其中脑梗死(CI)者24例，腔隙性脑梗死(LI)者18例，脑出血(ICH)者25例。检测各组患者的空腹血糖和餐前、餐后2小时的C肽及胰岛素浓度，并计算其胰岛素敏感指数，同时设对照组14例进行对比现察。结果：CI组及LI组的胰岛素敏感指数显著低于对照组，ICH组与对照组对比无显著性差异。脑卒中组中的胰岛素抵抗者有26例，占38．8％，主要见于肥胖或甘油三脂、低密度脂蛋白胆固醇、尿酸 、载脂蛋白B、高密度脂蛋白等指标中有三项以上异常的患者。结轮：胰岛素抵抗与缺血性脑卒中有密切关系，早期通过控制饮食、增加运动、药物治疗等方法降低人群的胰岛素抵抗，对脑卒中有积极的预防作用。

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

Objective:To study the relationship between insulin resistance(IR)and cerebral stroke.Methods:Sixty-seven patients with cerebral stroke were divided into cerebral infarction(CI)group(24 cases)\,lacunar infarction(LI)group(18 cases)and intracerebral hemorrhage(ICH)group(25 cases).Their fasting blood-glucose\,the concentration of C-peptide and insulin before and after breakfast two hours were measured,and the insulin sensitive indexes(ISI)were calculated and compared with those of the normal control group(14 cases).Results:The ISI of CI group and LI group were significantly lower than those of the normal control group( P <0.05).No significant differences were found between the ICH group and the normal control group( P>0.05).The cerebral stroke patients with IR(26 cases)were usually obese or had abnormalities of more than three lipid biochemistry indices(38\^8%).Conclusions:There was strong relationship between IR and ischemic cerebral stroke,Early intervention to decrease IR through diet\,sports and medicines in community population would be beneficial to the prevention of cerebral stroke.