胰岛素抵抗对糖耐量正常冠心病患者冠脉病变的影响

目的探讨胰岛素抵抗对糖耐量正常冠心病患者冠脉病变的影响。方法以112例冠心病患者为研究对象,采用自我平衡模型分析法(homeostasismodelassessment,HOMA)指数作为评价胰岛素抵抗的指标,将患者分为胰岛素抵抗组和胰岛素敏感组,应用多元逐步回归分析对相关危险因素进行分析。结果两组患者多支冠脉病变的发生率差异有统计学意义,弥漫性病变的发生率差异有极显著性意义,体重指数、收缩压、空腹血浆胰岛素、总胆固醇、甘油三酯与冠脉病变程度正相关,高密度脂蛋白-胆固醇与之呈负相关。结论冠心病合并胰岛素抵抗患者冠脉多支病变、多处病变及弥漫性病变的发生率高,提示胰岛素抵抗及其所造成的肥胖、高血压、脂质代谢紊乱是冠心病的独立危险因素。

Effects of insulin resistance on coronary artery changes in patients of coronary heart disease complicated with normal glucose tolerance

Objective To Study the effects of insulin resistance on coronary artery changes in patients of coronary heart disease complicated with normal glucose tolerance . Methods There were one hundred and twelve patients of coronary heart disease in the research, insulin resistance was assessed by homeostasis model assessment (HOMA) . All patients were examined by coronary angiographic semiquantitative(CAG), the related risk factors in coronary artery disease were analysed by pluralism straight line statistics. Result The coronary multivessel changes and the severity of coronary artery stenosis were more frequent in the IR group than those in the IS group. Distal coronary changes were more frequent in the IR group than those in the IS group . Hypertension?FPG?FINS?TC and TG were positively and HDL-C was negatively correlated with the coronary artery lesion. Conclusion The occurrence of coronary multivessel changes and the distal coronary changes were more frequent in the IR group than those in the IS group. These results suggest that insulin resistance, hyperlipemia and hypertension are all independent risk factors for the coronary artery disease.