脑梗死患者胰岛素抵抗与CRP,HCY,FIB水平、颈动脉IMT的相关性研究

目的 探讨脑梗死患者胰岛素抵抗(Insulin resistance,IR)与C反应蛋白(C-reactive protein,CRP)、同型半胱氨酸(Homocysteine,HCY)、血浆纤维蛋白原(Fibrinogen,FIB)水平、颈动脉内膜中层厚度(Inteima-media thickness,IMT)的相关性。方法 选择2014年1月-2015年1月入住本院神经内科的脑梗死患者260例纳入观察组,选择同期于本院进行健康体检志愿者260例纳入对照组; 观察组患者入院后24 h内检测空腹血糖(Fasting blood glucose,FBG)、总胆固醇(Total cholesterol,TC)、甘油三酯(Triglyceride,TG)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(High density liptein cholesterol,HDL-C)、空腹胰岛素(Fasting insulin,FINS)及外周血CRP,HCY,FIB水平; 计算胰岛素抵抗指数(Homa-insulin resistance index,HOMA-IR); 对照组同期进行上述指标水平检测; 按照是否发生IR将观察组分为IR组、非IR组,比较各组上述指标水平; 以Pearson相关分析评价HOMA-IR与其他各项指标水平的相关性。结果 观察组血清FBG,TC,TG,LDL-C,FINS及外周血CRP,HCY,FIB水平及IMT,HOMA-IR均高于对照组,血清HDL-C水平低于对照组(P<0.05); IR组血清FBG,TC,TG,LDL-C,FINS及外周血CRP,HCY,FIB水平及IMT,HOMA-IR均高于非IR组,血清HDL-C水平低于非IR组(P<0.05); 经Pearson相关分析显示,HOMA-IR与TC,TG,LDL-C,HDL-C水平无相关性(P>0.05),与FBG,FINS,CRP,HCY,FIB水平、IMT增加呈正相关(0.3<r<0.6,P<0.05)。结论 脑梗死患者胰岛素抵抗与CRP,HCY,FIB水平、颈动脉IMT增加呈正相关。

Correlation study between insulin resistance and CRP,HCY, FIB levels,carotid artery IMT in patients with cerebral infarction

ObjectiveTo study the correlation between insulin resistance and C-reactive protein(CRP), Homocysteine(HCY), plasma Fibrinogen(FIB)levels, Carotid artery IMT in patients with cerebral infarction.Methods 260 cases of patients with cerebral infarction admitted to the neurology department of our hospital from January 2014 to January 2015 were included in the observation group, and 260 cases of healthy volunteers who underwent physical examination in our hospital during the same period were included in the control group. Fasting blood glucose(FBG), Total cholesterol(TC), Triglyceride(TG), Low-density lipoprotein cholesterol(LDL-C), High-density lipoprotein cholesterol(HDL-C), Fasting insulin(FINS)and peripheral blood CRP, HCY and FIB levels were measured within 24 h after admission of observation group. Insulin resistance index(HOMA-IR)was calculated. In control group the same parameters was tested in the same period. According to the occurrence of IR, the observation group was divided into IR group and non-IR group. The parameter levels of each group were compared. Pearson correlation analysis was used to evaluate the correlation between HOMA-IR and other parameter levels.Results Serum FBG, TC, TG, LDL-C, FINS levels and peripheral blood CRP, HCY levels, IMT and HOMA-IR in the observation group were all higher than those in the control group, while serum HDL-C level was lower than that in the control group(P<0.05). Serum FBG, TC, TG, LDL-C, FINS levels and peripheral blood CRP, HCY, FIB levels, IMT and HOMA-IR in the IR group were higher than those in the non-IR group, while serum HDL-C level was lower than that in the non-IR group(P<0.05). Pearson correlation analysis showed that HOMA-IR had no correlation with TC, TG, LDL-C and HDL-C levels(P>0.05). It was positively correlated with FBG, FINS, CRP, HCY, FIB levels and IMT(0.3<r<0.6,P<0.05).Conclusion Insulin resistance of cerebral infarction patients was positively correlated with CRP, HCY, FIB levels and Carotid artery IMT.