CAJ | 학술논문

目的探讨胰岛素抵抗(IR)和血管内皮功能的相互关系,评价IR和血管内皮功能紊乱在急性冠状动脉综合征(ACS)中的作用.方法选择35例ACS、33例稳定型心绞痛(SA)和30例正常人作为对照组,采用放射免疫分析法和生化法分别测定空腹血清胰岛素和血糖水平,用稳态模型2计算机软件(HOMA2 Caculater)计算胰岛素抵抗指数(HOMA2-IR),应用超声诊断仪,测量肱动脉血管舒张功能,用SPSS11.5软件包进行统计分析.结果 ACS组和SA组HOMA2-IR显著高于对照组(P<0.001),内皮依赖性血管舒张功能显著低于对照组,ACS组HOMA2-IR显著高于SA患组(P<0.001),内皮依赖性血管舒张功能显著低于SA患者, ACS患者内皮依赖性血管舒张功能与胰岛素水平和HOMA2-IR呈显著负相关(P<0.001).结论血管内皮功能失调与高胰岛素血症和IR密切相关,三者与ACS的发生发展密切相关.
목적 탐토이도소저항(IR)화혈관내피공능적상호관계,평개IR화혈관내피공능문란재급성관상동맥종합정(ACS)중적작용.방법 선택35례ACS、33례은정형심교통(SA)화30례정상인작위대조조,채용방사면역분석법화생화법분별측정공복혈청이도소화혈당수평,용은태모형2계산궤연건(HOMA2 Caculater)계산이도소저항지수(HOMA2-IR),응용초성진단의,측량굉동맥혈관서장공능,용SPSS11.5연건포진행통계분석.결과 ACS조화SA조HOMA2-IR현저고우대조조(P<0.001),내피의뢰성혈관서장공능현저저우대조조,ACS조HOMA2-IR현저고우SA환조(P<0.001),내피의뢰성혈관서장공능현저저우SA환자, ACS환자내피의뢰성혈관서장공능여이도소수평화HOMA2-IR정현저부상관(P<0.001).결론 혈관내피공능실조여고이도소혈증화IR밀절상관,삼자여ACS적발생발전밀절상관.
Objective To explore the role of insulin resistance (IR) and endothelial function in the pathogenesis of acute coronary syndrome (ACS) through study on the correlation between IR and endothelial function in patients with ACS. Methods The endothelium dependent flow mediated dilatation (F-MD) and the endothelium independent nitroglycerin mediated dilatation (NTG-MD)were evaluated by the brachial ultrasound examination, Insulin (with radioimmunoassay RIA) , Fasting blood glucose (with biochemical method) levels were measured in 68 patients with coronary heart disease (ACS n=35;stable angina n=33) and 30 controls. IR were measured by HOMA2-IR(calculated from HOMA2 Caculater), analyzed by SPSS11.5. Results F-MD levels were significantly lower in the ACS patients and the stable angina (SA) patients than those in the controls(P<0.001); insulin levels and HOMA2-IR were significantly higher in the ACS patients and the SA patients than those in the controls(P<0.001); F-MD levels were significantly lower in the ACS patients than those in the SA(P<0.001), insulin levels and HOMA2-IR in the ACS patients were significantly higher than those in the SA(P<0.001); F-MD levels were significantly inverse correlated with those of insulin and HOMA2-IR(P<0.001). Conclusion The abnormal of endothelium function was closely correlated with high insulin level and IR , all of them play an important role in the occurrence and development of ACS.