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目的分析伴胰岛素抵抗的高血压病腔隙性脑梗死患者的代谢特征,为临床治疗提供理论依据。方法1999-6/2001-3在瑞金医院高血压科住院的高血压病患者,经头颅MRI检查确诊为腔隙性脑梗死者中,应用改良的Bergman的减少样本数微小模型方法评价高血压病非糖尿病伴腔梗患者的胰岛素敏感性,分析其胰岛素抵抗伴有的代谢紊乱。结果腰臀比:胰岛素抵抗组(38例)明显大于非胰岛素抵抗组(22例),差别有显著性意义(0.88±0.05vs0.85±0.06,t=2.15,P<0.05);胰岛素抵抗组三酰甘油明显高于非胰岛素抵抗组犤(2.41±0.06)mmol/Lvs(1.48±0.03)mmol/L,t=2.24,P<0.05犦;胰岛素抵抗组胰岛素敏感性和葡萄糖利用率明显低于非胰岛素抵抗组犤(4.0±0.6)min/mU·Lvs(4.8±0.6)min/mU·L,t=2.18,P<0.05;(2.12±0.17)/minvs(2.61±0.18)/min,t=2.24,P<0.05犦。结论高血压病非糖尿病伴腔隙性脑梗死的胰岛素抵抗患者同时伴有腹部肥胖和高三酰甘油。
Objective To analyze the metabolic characteristics of patients with hypertensive lacunar infarction with insulin resistance and to provide a theoretical basis for clinical treatment. Methods From June 1999 to March 2001, hypertensive patients admitted to the Department of Hypertension in Ruijin Hospital were enrolled in this study. Patients with lacunar infarction diagnosed by head MRI were evaluated with modified Bergman mini-model Insulin sensitivity in non-diabetic patients with leftover stem and analysis of metabolic disorders associated with insulin resistance. Results Waist-hip ratio was significantly higher in insulin resistant group (38 cases) than in non-insulin resistant group (22 cases) (0.88 ± 0.05 vs 0.85 ± 0.06, t = 2.15, P <0.05) Triglyceride was significantly higher than that in non-insulin resistance group (2.41 ± 0.06 mmol / L vs 1.48 ± 0.03 mmol / L, t = 2.24, P <0.05); Insulin sensitivity and glucose utilization were significantly lower in insulin resistance group In the non-insulin resistance group, the mean arterial pressure was (4.0 ± 0.6) min / mU · L vs (4.8 ± 0.6) min / mU · L, t = 2.18, = 2.24, P <0.05 犦. Conclusion Hypertensive patients with non-diabetic lacunar infarction insulin resistance accompanied by abdominal obesity and high triglyceride.