高血压病及伴脑腔隙性梗死患者胰岛素敏感性三项指标评价

目的　评价高血压病及伴脑腔隙性梗死患者的胰岛素敏感性情况。方法　 ( 1) 30名正常人及 14 3例高血压病人 (内含 10 3例腔隙性脑梗死患者 )均做口服 75g葡萄糖耐量试验 ,并按脑磁共振显像 (MRI)结果分成三组 :正常人组、有脑腔隙性病变 L( + ) ]组、无腔隙性病变 L( - ) ]组。 ( 2 )比较计算胰岛素敏感性的三种方法 :1(FGP×Fins) ,OGTT及InRT的曲线下面积 (AUC)比值 :AUCOGTT/AUCInRT及用Cederholm函数公式计算的Ins敏感指数 :Cederholm -ISI。( 3)分析胰岛素抵抗是否为脑部小血管病的危险因素。结果　 ( 1) 1/ (FPG×FIns)、AUCOGTT/AUCInRT及Cederholm -ISI,三种方法计算Ins敏感性指数 ,三种方法之间两两相关 (r=0 30 6 ,r =0 534 ,r=0 54 7,P <0 0 1)。 ( 2 )Cederholm -ISI在高血压病脑腔隙性有、无梗塞二组中有明显差异 (P <0 0 5)。结论　 ( 1)比较计算胰岛素敏感性的三种方法发现用Cederholm -ISI方法比 1/ (FPG×FIns)及AUCOGTT/AUCInRT更敏感。 ( 2 )胰岛素抵抗可能是脑部小血管病的重要的危险因素

Using Oral Glucose Tolerance Test and Insulin Release Test to Compare Three Evaluation Indexes of Insulin Sensitivity in Essential Hypertensive patient with or without Lacunar Infarction

Objective To inv estigate the insulin sensitivity in hype rtensive patients with or without lacuna r infarction.Methods Study i ncluded 30 normal subjects (control grou p)and 143 hypertension patients.All subj ects were divided into three groups:cont rol group (n=30);according to the result s of MRI,143 hypertension patients were again divided into two subgroups:hyperte nsive patients with lacunar infarction ( n=103) and without lacunar infarction (n =40).All subjects condrcted oral glucose tolerance test (OGTT) and insulin relea se test (InRT).All data were compared wi th three different calculation methods:1 /(FPG×FIns),AUC OGTT /AUC InRT and Ce derholm-ISI.Then to analyse whether insu lin resistance is a risk factor in hyper tensive patients with lacunar infarction .Results (1)1/(FPG×FIns),AUC OGTT /AUC InRT and Cederholm-ISI had positive correlation with each other (r =0 306,r=0 534,r=0 547, P <0 01,respectively).( 2)The significant difference of cederhol m-ISI was observed in hypertensive patie nts with and without lacunar infarction ( P <0 05).Conclusions (1)Ceder holm-ISI seems more sensitive than 1/(FP G×FIns) and AUC OGTT /AUC InRT to eva luate the insulin-sensitivity in hyperten sive patients.(2)Insulin resistance may be the risk factor of cerebral microvasc ular disease.