急性脑梗死患者胰岛素抵抗及其与肿瘤坏死因子-α关系的初步探讨

目的　探讨急性脑梗死患者胰岛素抵抗 (IR)与肿瘤坏死因子 α(TNF α)的关系。方法　检测了 42例急性脑梗死患者和 5 0例正常对照组的空腹血糖、血清胰岛素、C 肽、TNF α、TG及HDL含量 ,并计算胰岛素敏感指数 (ISI)。结果　急性脑梗死患者与正常对照组比较 ,ISI明显降低、血清TNF α明显升高 ,两者之间存在明显负相关关系 ;ISI与TG、HDL分别呈负相关、正相关关系。结论　急性动脉硬化性脑梗死患者存在着IR ,TNF α可能是IR形成的一个因素。抑制TNF α的表达可能会增加胰岛素敏感性 ,减少脑梗死的发生和减轻梗死范围。

The relationship between insulin resistance and TNF-α in patients with acute cerebral infarction

Objective To study the relationship between insulin resistance (IR) and TNF-α in patients with acute cerebral infarction. Methods Levels of fasting blood glucose, serum insulin, C-peptide, triglyceride (TG), high density lipoprotein (HDL) and TNF-α were measured in 42 patients with acute cerebral infarction and in 50 normal controls. Insulin sensitive index (INI) was also calculated. Results ISI in acute cerebral infarction was significantly lower and serum TNF-α was higher than that of the normal controls. The increasing degree of serum TNF-α was negatively correlated with ISI. ISI was negatively and positively correlated with TG and HDL, respectively. Conclusion IR exists in patients with acute atherosclerotic cerebral infarction. TNF-α may be a factor for the development of IR. Inhibiting TNF-α expression may increase insulin sensibility, reduce the incidence and extent of cerebral infarction.