【摘要】 目的 研究非糖尿病性急性心肌梗死(AMI)病人入院时胰岛素抵抗性、胰岛素敏感指数与预后的关系。方法 89例非糖尿病AMI患者入院时根据Killip分级评判心功能状况。Killip Ⅰ级(B组)53例,Killip Ⅱ级(C组)14例,Killip Ⅲ级(D组)12例,Killip Ⅳ级(E组)10例。以对58例健康正常人(A组)为正常对照。所有研究对象均分别检测其空腹血糖(FPG),空腹胰岛素(FINS)水平,计算胰岛素敏感指数(ISI),以稳态模型(Homa Model)公式评估胰岛素抵抗(IR),并计算住院病死率。结果 IR及FPG随着Killip分级的升高而升高,而ISI则显著逐渐下降;多元Logistic回归分析显示入院时的IR与Killip分级及住院病死率相关。结论 AMI患者入院时的胰岛素抵抗性越强预示着AMI的严重程度,胰岛素抵抗性越强病死率越高更多还原

【Abstract】 Objective To investigate the relationships of the insulin resistance (IR) and the insulin sensitivity index (ISI) with the prognosis and cardiac function in the patients with acute myocardiac infarction (AMI). Methods 89 AMI patients without diabetes mellitus (DM) were included in this study. The cardiac function were evaluated by Killip method while the AMI patients were admitted into hospital, and which were divided into 4 groups, the Killip I (53 cases), Killip II (14 cases), Killip Ⅲ(12 cases) and Killip IV (10 cases). 58 healthy persons were recruited as the controls. The fasting blood glucose (FBG) and fasting blood insulin were measured in all the subjects, and the IR and ISI were calculated. Results There was a positive relationship of the FBG, and IR, as well as a negative relationship of ISI, with Killip grade. The IR and ISI in Patents with Killip I had no significant difference fro those in health controls. Conclusion The level of IR, ISI and FBG may predict the severity of non-diabetic AMI patients. The more IR, the more severe AMI.更多还原