胰岛素抵抗 代谢综合征与冠状动脉病变相关性研究.docVIP

胰岛素抵抗 代谢综合征与冠状动脉病变相关性研究 　　【摘要】 目的 探讨胰岛素抵抗、代谢综合征各种危险因子与冠状动脉病变之间的关系。方法 将159例经冠状动脉造影确诊和排除冠心病患者分为两组，其中观察组83例，对照组76例。检测两组患者的空腹血糖、空腹胰岛素、血脂等生化指标，记录体重指数、高血压和糖尿病等代谢综合征危险因子，分析胰岛素抵抗指数（HOMAIR）、代谢综合征各种危险因子与冠脉狭窄指数的相关性。结果 观察组HOMAIR，甘油三脂、低密度脂蛋白水平显著高于对照组（P均＜0.01）；观察组高血压、糖尿病的发生率显著高于对照组（P＜0.05或＜0.01）；相关分析显示HOMAIR与甘油三脂、低密度脂蛋白和冠脉狭窄指数呈显著正相关（P均＜0.05）；多元Logistic回归分析显示冠心病的发病与HOMAIR、甘油三脂、低密度脂蛋白、高血压和糖尿病等代谢综合征危险因子有相关性（P＜0.05或＜0.01）。结论 胰岛素抵抗与冠状动脉病变程度呈密切正相关；胰岛素抵抗是冠心病独立危险因素之一。 　　?ぁ竟丶?词】 胰岛素抵抗；代谢综合征；冠心病?? 　　文章编号：1003-1383(2008)04-0393-03中图分类号：R 541.4 文献标识码：A?? 　　 　　Correlation of insulin resistance and metabolic syndrome with?? 　　coronary heart disease?? 　　YIN Jianbin,WEI Jinyu,ZUO Liuan，CHEN Shizhong,??JANG Fangyoug,CAO Yanqing,XIE Xiaodan?? 　　（Cardiovascular Department of Liuzhou Peoples Hospital, the Fifth Affiliated Hospital of ?? 　　Guang Xi Medical University, Liuzhou 545001 Guangxi）?? 　　【Abstract】 Objective To investigate the correlation of insulin resistance,metabolic syndrome and coronary heart disease. 　　Methods 159 patients diagnosed by coronary angiographic（CAG）were enrolled into this research,83 in coronary heart disease(CHD) group and 76 in normal control group without coronary heart disease. The levels of fasting blood glucose,blood insulin and plasma lipids respectively and recorded BMI,hypertension,diabetes mellitus in both groups were detected. Analyzed the correlation of homeostasis model assessment of insulin resistance(HOMAIR), components of metabolic syndrome and the degree of coronary artery stricture between the two groups.Results HOMAIR,levels of triglyceride,LDL,and the number of hypertension,diabetes mellitus in CHD group were higher than that in normal control group(P＜0.05); There were significant positive corelation between HOMAIR,triglyceride,LDL and coronary artery stricture(r=0.556,P＜0.05；r=0.745,P＜0.05；r=0.627,P＜0.05);Coronary heart disease were related with HOMAIR, components of metabolic syndrome.Con 　　clusion There were significant positive correlati