摘要
目的 探讨急性脑卒中患者血浆胰岛素样生长因子 1(IGF 1)及其结合蛋白 3(IGFBP3)水平的变化 ,及两者与胰岛素抵抗 (IR)有关的血浆胰岛素 (FINS)水平及其敏感性系数 (ISI)的相关性。方法 应用放射免疫法检测了 4 0例急性脑出血 (ACH)患者、34例脑梗死 (ACI)患者、脑卒中恢复期组30例和正常对照组 30名的血浆IGF 1、IGFBP3、FINS水平 ,同时测定空腹血糖 (GS)水平。结果 (1)ACI和ACH组血浆IGF 1、IGFBP3、ISI显著低于正常对照组和脑卒中恢复期组 (分别为ACI:17 3mmol/L± 7 0mmol/L ,72 9mmol/L± 11 4mmol/L ,- 4 2± 0 3;ACH :14 4mmol/L± 5 8mmol/L ,5 7 8mmol/L± 17 2mmol/L ,- 4 7± 0 6 ,恢复期组 :2 8 8mmol/L± 13 6mmol/L ,87 4mmol/L± 18 3mmol/L ,- 3 9±0 4 ;正常对照组 :31 5mmol/L± 18 9mmol/L ,93 1mmol/L± 2 8 0mmol/L ,- 3 6± 0 3;F分别为 18 3,2 0 2 ,17 2 ,P <0 0 1;GS、FINS显著高于正常对照组 (ACI组 :6 1mmol/L± 1 0mmol/L ,15 7mIU/L±3 1mIU/L ;ACH组 :6 4mmol/L± 2 1mmol/L ,19 7mIU/L± 9 6mIU/L ;正常对照组 :4 8mmol/L± 0 5mmol/L ,10 6mIU/L± 3 2mIU/L ;F分别为 8 5 ,10 6 ;P <0 0 1) ;(2 )ACI组和ACH组血浆IGF 1与IGFBP3水平呈正相关
Objective To study the changes of plasma insulin like growth factor 1(IGF 1) and IGF binding protein 3 (IGFBP3) in patients with acute cerebral infarct (ACI) and acute cerebral hemorrhage (ACH) and the correlation of IGF 1 and IGFBP3 with plasma fasting insulin (FINS) related to insulin resistance (IR) and with insulin sensitive index (ISI) Methods The plasma IGF 1, IGFBP3 and FINS of 34 patients with ACI and 40 patients with ACH (within 2 days after onset) were measured by radioimmunoassay Meanwhile, the fasting blood glucose (GS) of these patients was measured 30 patients with ACH during convalescence (3～6 months after stroke) and 30 age matched healthy individuals served as control gruops Results (1) The plasma IGF 1 and IGFBP3 and ISI were 17 3±7 0 mmol/L, 72 9±11 4 mmol/L and -4 2±0 3 respectively in the ACI group, 14 4±5 8 mmol/L ,57 8±17 2 mmol/L and -4 7±0 6 in the ACH group; 28 8±13 6 mmol/L ,87 4±18 3 mmol/L and -3 9±0 4 in the convalwscence group; and 31 5±18 9 mmol/L , 93 1± 28 0 mmol/L and -3 6±0 3 in the healthy control group The values in the former two groups were significantly lower than those in the two control groups ( F =18 3,20 2 and 17 2 respectively, P <0 01) The plasma glucose was 6 1±1 0 mmol/L in ACI group, 6 4±2 1 mmol/L in ACH group, and 4 8 ±0 5 mmol/L in healthy control group ( F =8 5, P <0 01) The plasma FINS was 15 7±3 1 mIU/L in ACI group, 19 7 ±9 6 mIU/L in ACH group, and 10 6±3 2 mIU/L in healthy control group ( F =10 6, P <0 01) (2) In patients with ACI and ACH, there was a significant positive correlation between plasma IGF 1 and IGFBP3 ( P <0 01), between plasma IGF 1 and ISI ( P <0 01), and between IGFBP3 and ISI ( P <0 05); and there was a significant negative correlation between plasma IGF 1 and FINS and between IGFBP3 and FINS ( P <0 01) Conclusion The plasma IGF 1 and IGFBP3 participates in the pathophysiologic course of ACI and ACH in the early stage Insulin resistance exists in ACI and ACH Plasma IGF 1 may play an important role in IR in ACI and ACH
出处
《中华医学杂志》
CAS
CSCD
北大核心
2002年第6期410-412,共3页
National Medical Journal of China
