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背景:肿瘤坏死因子α(tumornecrosisfactor-α,TNF-α)和胰岛素抵抗(insulinresistance,IR)都是脑血管病的危险因素,拮抗TNF-α能否改善IR及减轻脑血管病患者脑损伤?目的:探讨急性脑梗死患者TNF-α和IR的改变及其相互关系。设计:以诊断为依据的病例对照研究。地点和对象:广西壮族自治区百色市人民医院2000-01/2003-02符合全国第二次脑血管病会议诊断标准的48例急性脑梗死患者(急性脑梗死组)和36例健康体检者(正常对照组)。干预:所有入选对象均于清晨空腹抽取静脉血测定血糖(fastingplasmaglucose,FPG),血清胰岛素(fastinginsulin,FINS),TNF-α。血糖测定方法采用氧化酶法,血清胰岛素测定用放射免疫法,TNF-α采用酶标法。主要观察指标:急性脑梗死组和正常对照组的FPG,FINS,TNF-α的水平。结果:急性脑梗死组的TNF-α水平为(205±78)ng/L,FINS为(6.18±1.72)mmol/L,FPG为(12.74±4.33)mU/L,均高于对照组犤(76±18)ng/L,(5.25±1.28)mmol/L,(7.18±2.58)mU/L犦,其中急性脑梗死组的TNF-α水平和FINS与对照组比较,差异有显著性意义(t=9.72,7.33,P<0.01);血清TNF-α与FINS呈正相关(r=0.53,P<0.01)。结论:急性脑梗死患者可有IR和TNF-α水平增高,TNF-α与IR有密切相关性,两者可能共同参与缺血性脑血管病的发生和?
BACKGROUND: Tumor necrosis factor-α (TNF-α) and insulin resistance (IR) are the risk factors of cerebrovascular disease. Can antagonism of TNF-α improve IR and relieve brain injury in patients with cerebrovascular disease? To investigate the changes of TNF-α and IR in patients with acute cerebral infarction and their correlation. Design: A case-control study based on diagnosis. Place and Subject: Baise People’s Hospital of Guangxi Zhuang Autonomous Region 2000-01 / 2003-02 In 48 patients with acute cerebral infarction (acute cerebral infarction group) and 36 healthy people (normal Control group). Intervention: All subjects were fasting plasma glucose (FPG), fastinginsulin (FINS) and TNF-α in fasting morning. Blood glucose determination using oxidase method, serum insulin determination by radioimmunoassay, TNF-α using enzyme-labeled method. MAIN OUTCOME MEASURES: The levels of FPG, FINS and TNF-α in acute cerebral infarction group and normal control group. Results: The levels of TNF-α in acute cerebral infarction group were (205 ± 78) ng / L, FINS was (6.18 ± 1.72) mmol / L and FPG was (12.74 ± 4.33) mU / L, 76 ± 18 ng / L, 5.25 ± 1.28 mmol / L and 7.18 ± 2.58 mU / L respectively. There was significant difference between the levels of TNF-α and FINS in the acute cerebral infarction group and the control group t = 9.72, 7.33, P <0.01). Serum TNF-α was positively correlated with FINS (r = 0.53, P <0.01). Conclusion: Patients with acute cerebral infarction may have elevated levels of IR and TNF-α, TNF-α and IR are closely related, both may participate in the occurrence of ischemic cerebrovascular disease and?