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探讨高血压性脑出血（HIH）患者是否存在胰岛素抵抗（IR）与高胰岛素血症（HIS），以及IR与患者病情、预后的关系。方法测定了56例HIH患者及37例原发性高血压（EH）患者、49例健康人的血糖（FPG）与血清胰岛素水平（FINS），同时采用李光伟等提出的胰岛素敏感性指数（ISI）方法进行计算，3个月后随访HIH患者，进行日常生活能力（ADL）Barthel指数评分。结果HIH患者FPG及FINS均明显高于对照组（P＜0．001，P＜0．001），其ISI较对照组明显减低（P＜0．001）。HIH患者轻型组与重型组的FPG、FINS、ISI比较也存在显著性差异（P＜0．001，P＜0．05，P＜0．001）。随访HIH患者轻型组ADL评分明显高于重型组。结论HIH患者存在IR及HIS，其胰岛素水平及IR程度与患者病情、预后有关。建议对HIH患者的血糖水平升高与IR及ISI下降者应积极使用改善胰岛素敏感性的药物治疗。
To investigate whether there is insulin resistance (IR) and hyperinsulinemia (HIS) in patients with hypertensive intracerebral hemorrhage (HIH), and the relationship between IR and disease status and prognosis. Methods The blood glucose (FPG) and serum insulin (FINS) were measured in 56 patients with HIH and 37 patients with essential hypertension (EH) and 49 healthy people. The insulin sensitivity index (ISI) Methods Three-month follow-up of HIH patients was performed to assess Barthel index of ADL. Results The FPG and FINS of HIH patients were significantly higher than those of the control group (P <0.001, P <0.001), and the ISI of the HIH patients was significantly lower than that of the control group (P <0.001). There were also significant differences in FPG, FINS and ISI between light and heavy groups in HIH patients (P <0.001, P <0.05, P <0.001). Follow-up HIH patients with mild ADL score was significantly higher than the heavy group. Conclusion There are IR and HIS in HIH patients. The level of insulin and IR are related to the patient’s condition and prognosis. Recommendations for HIH patients with elevated blood glucose and IR and ISI decreased should be actively used to improve insulin sensitivity of drug treatment.