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目的 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与患者病情和预后的关系。方法 采用胰岛素敏感性指数（ISI）方法测定56例高血压性脑出血患者、37例原发性高血压患者血糖（FPG）和血清胰岛素水平（FINS）,并与49例健康人进行对照;3个月后对存活的高血压性脑出血患者进行随访并进行日常生活能力（ADL）Barthel指数评分。结果 高血压性脑出血患者血糖及血清胰岛素均明显高于对照组（P<0.01）,ISI较对照组明显减低（P<0.001）。高血压性脑出血患者轻型组与重型组的血糖、血清胰岛素、ISI也存在显著性差异（P<0.001,P<0.05,P<0.001）。随访高血压性脑出血患者ADL评分轻型组明显高于重型组。结论 高血压性脑出血患者存在IR及高胰岛素血症,其胰岛素水平及IR程度与患者病情和预后有关。
Objective To investigate the relationship between 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) in 56 patients with hypertensive intracerebral hemorrhage and 37 patients with essential hypertension were measured by insulin sensitivity index (ISI) and compared with 49 healthy controls. 3 Months later, patients with hypertensive intracerebral hemorrhage who were alive were followed up and were assessed for Barthel Index (ADL). Results The blood glucose and serum insulin in patients with hypertensive intracerebral hemorrhage were significantly higher than those in the control group (P <0.01). The ISI was significantly lower than that in the control group (P <0.001). There were significant differences in blood glucose, serum insulin and ISI between light and heavy groups in patients with hypertensive intracerebral hemorrhage (P <0.001, P <0.05, P <0.001). Follow-up patients with hypertensive cerebral hemorrhage ADL score was significantly higher in the light group than in the heavy group. Conclusion There are IR and hyperinsulinemia in patients with hypertensive intracerebral hemorrhage. The level of insulin and the degree of IR are related to the patient’s condition and prognosis.