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目的探讨脑出血及脑梗死患者急性期是否存在胰岛素抵抗 ( IR) ,并了解 IR与患者血清肿瘤坏死因子 -α( TNF-α)的关系。方法测定 3 5例急性期脑梗死患者与 3 0例急性期脑出血患者及 2 4例健康人的血糖与血清胰岛素水平。并采用胰岛素敏感性指数 ( ISI)方法进行计算 ,同时测定他们的血清肿瘤坏死因子 -α,对 ISI与 TNF-α进行相关分析。结果脑出血组及脑梗死组 FSG及 FINS增加明显高于对照组 ( P<0 .0 1) ,其 ISI较对照组明显降低 ( P<0 .0 1) ,其 TNF -α也较对照组明显增高 ( P<0 .0 5 ,P<0 .0 1)。相关分析表明脑梗死组血清 TNF-α与 ISI呈负相关 ( r=-0 .5 2 ,P<0 .0 1) ,脑出血组 TNF-α与 ISI呈负相关 ( r=-0 .79,P<0 .0 1)。结论急性期脑梗死与脑出血均存在胰岛素抵抗 ,且血清 TNF-α水平与 IR密切相关 ,因此 ,降低急性期脑血管病患者的血清 TNF-α对改善胰岛素抵抗是重要的。
Objective To investigate the existence of insulin resistance (IR) in patients with acute cerebral hemorrhage and cerebral infarction and to investigate the relationship between IR and serum tumor necrosis factor-α (TNF-α). Methods Blood glucose and serum insulin levels were measured in 35 patients with acute cerebral infarction and 30 patients with acute cerebral hemorrhage and 24 healthy controls. The serum levels of TNF-α were measured by insulin sensitivity index (ISI). Correlation analysis between ISI and TNF-α was performed. Results The increase of FSG and FINS in cerebral hemorrhage group and cerebral infarction group was significantly higher than that in control group (P <0.01), and the ISI was significantly lower than that in control group (P <0.01) Was significantly higher (P <0.05, P <0.01). Correlation analysis showed that there was a negative correlation between serum TNF-α and ISI in cerebral infarction group (r = -0.52, P <0.01), but negatively correlated with ISI in cerebral hemorrhage group (r = -0.79 , P <0. 01). Conclusions Both acute cerebral infarction and intracerebral hemorrhage have insulin resistance, and serum TNF-α level is closely related to IR. Therefore, reducing serum TNF-α in patients with acute cerebrovascular disease is important for improving insulin resistance.