不同亚型脑梗死和胰岛素抵抗关系研究.docVIP

不同亚型脑梗死和胰岛素抵抗关系研究 　　【摘要】 目的：探讨不同亚型急性脑梗死与胰岛素抵抗关系。方法：选取脑梗死患者101例分为动脉粥样硬化血栓形成组（Atherothrombotic infarction ，AT组）、急性穿支小动脉闭塞组（Acute perforating small artery occlusion，APSAO组）、心源性栓塞组（Cardioembolic infarction，CE组）三组，比较三组患者胰岛素抵抗指数（Homeostasis model assessment for insulin resistance，HOMA-IR）值。结果：AT组中糖代谢异常（abnormal glucose metabolism，AGM）患者HOMA-IR值远远大于CE组AGM患者（P0.01）。APSAO组HOMA-IR值亦高于CE组（P0.05）。AT组中AGM患者的HOMA-IR值远远大于正常糖代谢（Normal glucose tolerance，NGT）患者（P0.01）。APSAO组中AGM患者的HOMA-IR值亦大于NGT患者（P0.05）。结论：胰岛素抵抗与动脉粥样硬化血栓形成、急性穿支小动脉闭塞脑梗塞均密切相关，对胰岛素抵抗的及早干预在脑梗塞的二级预防中尤其重要。 　　【关键词】 脑梗死亚型； 胰岛素抵抗； 关系 　　【Abstract】 Objective： To assess the relationship between subtypes of ischemic stroke and insulin resistance.Method：101 enrolled patients diagnosed with cerebral infarction were divided into 3 groups，atherothrombotic infarction group（AT group ）；acute perforating small artery occlusion group（APSAO group） and cardioembolic infarction group（CE group）.We investigated the relationships between ischemic stroke subtypes and the prevalence of insulin resistance used by homeostasis model assessment for insulin resistance（HOMA-IR）.Result： The mean of HOMA-IR was significantly increase in the AT group with AGM compared to the CE group， the difference was statistically significant（P0.01）.The mean of HOMA-IR was also higher in the APSAO group with AGM than the CE group， the difference was statistically significant（P0.05）. The mean of HOMA-IR was significantly increase in the AT group with AGM compared to the NGT，the difference was statistically significant（P0.01）. The mean of HOMA-IR was also higher in the APSAO group with AGM than the NGT，the difference was statistically significant（P0.05）.Conclusion： insulin resistance is not only associated closely with atherothrombotic infarction， but also has a close relationship with acute perforating small artery occlusion infarction.Early intervention and treatment for insulin resistance seems to be important for the secondary prevention of ischemic stroke. 　　【