胰岛素抵抗及内皮素与冠状动脉病变关系的探讨

目的:研究冠心病患者胰岛素抵抗、内皮素(ET)与不同类型冠心病及不同冠状动脉(冠脉)病变的关系。方法:对2004年9月~2005年8月收治的52例冠心病患者(不稳定型心绞痛组29例,稳定型心绞痛组23例)和16例健康人(正常对照组)均行胰岛素敏感指数(ISI)、ET测定及冠脉造影检查,按冠脉造影结果将冠脉病变分为A、B、C 3型。结果:①冠心病组与正常对照组ET比较有统计学差异(P<0.01);②冠心病组冠脉狭窄程度与体内ET水平呈明显正相关(rs=0.403,P<0.01),与ISI水平呈明显负相关(rs=-0.403,P<0.01)。不稳定型心绞痛C型病变者血浆ET水平最高,ISI最低;A型病变者血浆ET水平最低,ISI最高。结论:冠心病患者尤其是不稳定性心绞痛患者ET水平明显增高,ISI明显降低且与冠脉狭窄程度密切相关。

The Relationship among Insulin Resistance, Endothelins and Coronary Artery Lesion in Patients with Coronary Heart Disease

Objective:To study the relationship among insulin resistance(IR),endothelins(ET) and coronary artery lesion.Methods:Insulin resistance index(ISI),ET were measured and coronary arteriography was done in 52 patients with CHD(29 stabile angina pectoris patients and 23 unstable angina pectoris patients) and 16 healthy subjects.CHD patients were divided into 3 groups(type A,B and C)based on the coronary artery lesions.Results:1.Patients in CHD group had significantly higher plasma ET levels and lower ISI than those in the control group(P<0.01).2.The ISI was negatively correlated with the degree of coronary lesions(rs=-0.423,P<0.01)and the ET level was positively correlated with the degree of coronary lesions(rs=0.403,P<0.01;rs=0.452,P<0.01).3.The plasma ET level was the highest and ISI was the lowest in(P<0.01) with unstable angina pectoris patients typec.The plasma ET levels was the lowest and ISI was the highest in group A with unstable angina pectoris patients(P<0.01).Conclusion:The levels of plasma ET and ISI are related with the degree of coronary artery lesion in patients with CHD,especial in patients with unstable angina pectoris.