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溶栓治疗对急性心肌梗死患者胰岛素敏感性的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2000年第2期
页码:
96-97, 99
栏目:
论著
出版日期:
2000-03-25

文章信息/Info

Title:
Effect of thrombolytic therapy on the change in insulin resistance in patients with acute myocardial infarction
作者:
刘四海;  贾国良;  郭文怡
第四军医大学西京医院心内科, 陕西西安710032
Author(s):
LIU Si-hai; JIA Guo-liang; GUO Wen-yi
Department of Cardiology; Xijing Hospital; Fourth Military Medical University; Xi’an 710032; Shaanxi; China;
关键词:
溶栓治疗;  心肌梗死;  急性;  胰岛素抗药性
Keywords:
thrombolytic therapy;  myocardial infarction;  acute;  insulin resistance
分类号:
Q578
DOI:
-
文献标识码:
A
摘要:
探讨溶栓治疗对急性心肌梗死(AM I) 患者空腹胰岛素及胰岛素抵抗的影响。检测20 例溶栓治疗和22 例未溶栓治疗的非糖尿病AM I 患者的空腹血糖, 空腹胰岛素及胰岛素敏感性指数, 并与20 例正常人作比较, AM I 患者4 周后复查。结果:AM I 两组在急性期存在高胰岛素血症和胰岛素抵抗, 4 周后复查血胰岛素水平, 胰岛素敏感性指数较急性期有明显下降(P < 0. 01) ,AM I 溶栓治疗组的空腹胰岛素和胰岛素敏感性指数较未溶栓治疗组显著下降(P < 0. 05)。结论:AM I 存在高胰岛素血症及胰岛素抵抗, 以急性期最明显, 早期溶栓治疗能促进空腹胰岛素及胰岛素敏感性指数的下降。
Abstract:
To investigate whether there were difference betweenn the serum insulin(Ins) and insulin sensitivity index (ISI) in acute myocardial infarction (AMI) patients with thrombolytic therapy and those in AMI patients with nonthrombolytic therapy,the concentrations of fasting blood glucose (FBG),Ins were measured in 20 non diabetic AMI patients with thrombolytic therapy,22 non_diabetic AMI patients with non thrombolytic therapy and 20 healthy controls. The ISI of each group was calculated and compared. The FBG and Ins of AMI patients were again measured 4 weeks latter. Both of the AMI group s had a significantly greater mean FBG and Ins and ISI than those of the control group in acute period. The Ins and ISI of the AMI groups had a significantly drop in the following 4 week s (P < 0. 01). Compared with the AMI patient s of non-thrompolytic therapy, the AMI patient s with thrombolytic therapy showed low Ins and ISI (P <0. 05). The AMI patient s suffered hyperinsulinemia and insulin resistance which were more significant in acute period. Thrombolytic therapy can decrease Ins and ISI

参考文献/References

［1］Reaven GM. Banting lecture: Role of insulin resistance in human disease[J ]. Diabetes, 1998, 87: 1595.

[2]　李光伟, 潘孝仁. 检测人群胰岛素敏感性的一项新指数[J ]. 中华内科杂志, 1993, 10: 656.

[3]　俞茂华, 钟学礼. 肥胖症[M ]. 见: 戴自英. 实用内科学[M ].上册. 第9 版. 北京: 人民卫生出版社, 1993: 667～ 672.

[4] Walton C, Godslanel IF, Proudler AJ, et al. Effect of body mass index and fat distribution on insulin sensitivity, section and clearance in nonobese healthy man[J ]. J Clin Endocrinol Metab, 1992, 75: 17.

[5] Schnerier DJ , Nordt TK, Ferrannin E, et al. Attenuated fibrinolysis and accelerated atherogenesis in type II diabetic patients[J ]. Diabetes, 1993, 42: 1.

[6] Landin K, Tengborn L , Smith U. Elevated fibrinogen and plasminoge activator inhibitor (PA I21 ) in hypertension are related to metabolic risk factors for cardiovasular disease[J ]. J Intern Med , 1990, 227 (4) : 273.

[7] Bavenholm P, Proudler A , Silveria A , et al. Relationships of insulin and intact and split proinsulin to haemostatic function in young man with and without coronary artery disease [J ]. Thromb Haemost, 1995, 73: 568.

备注/Memo

备注/Memo:
收稿日期：1999-04-26.
更新日期/Last Update: 2000-03-25