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目的明确脑梗死患者存在胰岛素抵抗 (IR) ,探讨IR与血浆纤溶酶原激活物抑制物 1 (PAI 1 )的关系。方法选择62例脑梗死患者和 35例健康体检者。测定空腹血糖 (FBG)、空腹胰岛素 (FINS)浓度和血浆PAI 1活性。计算胰岛素敏感指数 (ISI) ,并与神经功能缺失评分、梗死灶面积和PAI 1进行直线相关分析。结果脑梗死患者FBG、FINS和PAI 1显著高于对照组 ;ISI显著低于对照组。脑梗死轻型组与脑梗死重型组之间FINS、ISI和PAI 1存在显著差异。ISI与梗死灶面积、神经功能评分和PAI 1呈负相关 ;PAI 1与梗死灶面积和神经功能缺失评分呈正相关。结论脑梗死患者存在胰岛素抵抗和纤溶活性的降低 ;IR和PAI 1与脑梗死患者病情轻重密切相关 ,IR和PAI 1活性增高可能导致脑梗死的形成和发展
Objective To investigate the existence of insulin resistance (IR) in patients with cerebral infarction and to explore the relationship between IR and plasma plasminogen activator inhibitor 1 (PAI 1). Methods Sixty-two patients with cerebral infarction and 35 healthy subjects were selected. Fasting blood glucose (FBG), fasting insulin (FINS) concentration and plasma PAI 1 activity were measured. Insulin sensitivity index (ISI) was calculated and linear correlation analysis was performed with neurological deficit score, infarct size, and PAI 1. Results The levels of FBG, FINS and PAI 1 in patients with cerebral infarction were significantly higher than those in control group; ISI was significantly lower than that in control group. There were significant differences in FINS, ISI and PAI 1 between mild infarction group and severe infarction group. ISI was negatively correlated with infarct size, neurological function score and PAI 1. PAI 1 was positively correlated with infarct size and neurological deficit score. Conclusions There is a decrease in insulin resistance and fibrinolytic activity in patients with cerebral infarction. IR and PAI 1 are closely related to the severity of cerebral infarction. Increased activity of IR and PAI 1 may lead to the formation and development of cerebral infarction