高胰岛素血症与腔隙性脑梗死的相关性研究

目的 明确高胰岛素血症是否为腔隙性脑梗死的独立危险因素。并探讨其机制。方法 选取41例脑梗死患者，分为腔隙性脑梗死组和大血管病变组，并设立非脑血管病对照组。测定3组的空腹血糖，血脂及空腹血胰岛素等生化指标。采用成组t检验进行统计分析。结果 腔隙性脑梗死组空腹血胰岛素明显高于大血管病变组及对照组。甘油三酯明显高于对照组。结论 高胰岛素血症主要引起脑小血管病变，对大血管影响较小；高胰岛素血症可能是腔隙性脑梗死的独立危险因素；脂质代谢紊乱，特别是甘油三酯水平升高是高胰岛素血症重要致病机制之一。

The relationship of hyperinsulinism and lacunar infarction

Objective To identify whether hyperinsulinism is an independent risk factor for lacunar infarction and to discuss its possible mechanism. Methods The levels of free serum glucose,lipids,lipoproteins and insulin were compared between lacunar infarction group,macroangiography group and control group. Results Compared with macroangiopathy group and control group,the plasma levels of insulin in the lacunar infarction group were significantly higher ( P <0.05);compared with control group,the levels of TG in lacunar infarction group were significantly increased ( P <0.05),while the levels of HDL C were lower but failed to show statistical significance (0.05< P <0.10). Conclusion Hyperinsulinism really plays a role in the development of cerebrovascular diseases,especially in those mainly based on changes of small vessels. It may be an independent risk factor for lacunar infarction. Hyperinsulinism disturbs lipids metabolism,which may contribute to pathogenesis of lacunar infarcts.