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目的探讨冠心病非糖尿病患者胰岛素抵抗与支架内再狭窄(in-stent restenosis,ISR)的相关性。方法经皮冠状动脉介入治疗冠心病非糖尿病患者78例,根据术后6个月冠状动脉造影结果分为ISR组32例和NISR组46例;比较支架植入前2组空腹血糖、餐后2h血糖及血清胰岛素水平,计算胰岛素AUC、胰岛素抵抗指数。结果 ISR组患者支架植入前空腹胰岛素[(12.12±1.23)u/mL]、胰岛素AUC(204.70±26.50)、胰岛素抵抗指数(2.92±0.44)高于NISR组[(10.01±1.32)u/mL、135.90±23.10、1.86±0.38),差异有统计学意义(P<0.01);空腹胰岛素(r=0.83,P=0.01)、胰岛素AUC(r=0.71,P=0.03)、胰岛素抵抗指数(r=0.67,P=0.04)与术后6个月管腔狭窄程度呈正相关。结论冠心病非糖尿病患者胰岛素抵抗情况可作为预测ISR的指标。
Objective To investigate the relationship between insulin resistance and in-stent restenosis (ISR) in non-diabetic patients with coronary heart disease. Methods Percutaneous coronary intervention in coronary heart disease in 78 patients with non-diabetic patients, according to 6-month coronary angiography results were divided into ISR group of 32 patients and NISR group of 46 patients; comparison before stent implantation 2 fasting blood glucose, postprandial 2h Blood glucose and serum insulin levels, calculated insulin AUC, insulin resistance index. Results Compared with NISR group, [(12.12 ± 1.23) u / mL], insulin AUC (204.70 ± 26.50) and insulin resistance index (2.92 ± 0.44) in ISR group were significantly higher than those in NISR group [ , 135.90 ± 23.10 and 1.86 ± 0.38 respectively), the difference was statistically significant (P <0.01); the fasting insulin (r = 0.83, P = 0.01), insulin AUC (r = 0.71, = 0.67, P = 0.04) was positively correlated with the degree of stenosis at 6 months after operation. Conclusion Insulin resistance in non-diabetic patients with coronary heart disease can be used as an index to predict ISR.