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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(HOMA2Caculater)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。
Objective To investigate the relationship between insulin resistance (IR) and endothelial function and evaluate the role of IR and endothelial dysfunction in acute coronary syndrome (ACS). Methods 35 cases of ACS, 33 cases of stable angina (SA) and 30 normal controls were selected as control group. Fasting serum insulin and blood glucose levels were determined by radioimmunoassay and biochemical methods. The steady-state model 2 computer software (HOMA2Caculater) The insulin resistance index (HOMA2-IR) was calculated. The diastolic function of brachial artery was measured by ultrasonic diagnostic apparatus. The data were analyzed by SPSS11.5 software package. Results HOMA2-IR in ACS group and SA group was significantly higher than that in control group (P <0.001), and endothelium-dependent vasodilation was significantly lower than that in control group. HOMA2-IR in ACS group was significantly higher than that in SA group (P <0.001) Dependent vasodilation was significantly lower in patients with SA than in patients with SA. Endothelium-dependent vasodilation was negatively correlated with insulin levels and HOMA2-IR in patients with ACS (P <0.001). Conclusions Vascular endothelial dysfunction is closely related to hyperinsulinemia and IR, and the three are closely related to the occurrence and development of ACS.