胰岛素抵抗与血清循环内分泌因子在冠心病发病中的作用

目的　研究胰岛素抵抗与血清循环内分泌因子在冠心病发病中的作用。方法　分别测定 52例老年冠心病患者〔冠心病组 ,其中不稳定心绞痛 ( UAP组 ) 3 0例 ,急性心肌梗死 ( AMI组 ) 2 2例〕及 3 0例健康人 (对照组 )血浆 t-PA (组织型纤溶酶原激活物 )、PAI(纤溶酶原激活物抑制物 )、ET(内皮素 )、SOD(超氧化物歧化酶 )、L PO (过氧化脂质 )、Ins(胰岛素 )、C-P( C-肽 )等及血清甲状腺激素 T3、T4、r T3(反 T3)、FT3(游离 T3)、FT4(游离T4)、TSH(促甲状腺激素 )和血脂水平 ,并进行对照分析。结果　冠心病组 (尤其是 AMI组患者 ) Ins、C-P、Ins/ SG(胰岛素 /血糖 )、IAI(胰岛素敏感指数 ) PAI、ET、L PO、r T3均比对照组显著升高 ( P<0 .0 1及 P<0 .0 5) ;而 t-PA、SOD、T3、FT3、T4 比对照组降低 ( P<0 .0 1及 P<0 .0 5)。结论　老年冠心病患者存在胰岛素抵抗 ,ET增加 ;PAI升高及 t-PA降低诱发了冠脉内的粥样硬化斑块破裂或出血 ,血小板聚集及血栓形成 ,从而促发 UAP或 AMI。血清甲状腺激素的变化对了解心肌梗死患者的心肌坏死量 ,判断病情及预后有一定帮助

The relationship of insulin resistance and circle endocrine factor in coronary heart disease

Objective To explored the relationship among insulin resistance and circle endocrine factor in coronary heart disease (CHD).Methods 52 patients with CHD as CHD groups,which were divided into UAP group (30) and AMI group (22),were measured plasma t PA, PAI, ET, SOD, LPO, Ins, C P and serum levels of thyroid hormone T 3, T 4, rT 3, FT 3, FT 4, TSH.30 healthy subjects were taken as control group.Results Ins, C P,Ins/SG, IAI ?PAI?ET?LPO ?rT 3 were significant increased (P<0.01 and P<0.05)and t PA, SOD ,Serum T 3, T 4, FT 3 were reduced in CHD groups (especially in AMI groups) than those in controls.Conclusion The analysis suggests that insulin resistance,increasing ET,PAI and reducing t PA can induce atherosclerosis plaque in coronary rupturing or bleeding and thrombosis plays an important role in UAP and AMI.Serum levels of thyroid hormone are beneficial to know the quantity of myocardial infarctions and to judge the state and prognosis in patients with AMI.