急性心肌梗塞左心功能与胰岛素抵抗的关系

为探讨急性心肌梗塞恢复期患者左心功能与胰岛素抵抗的关系，对26例急性心肌梗塞恢复期患者和20例健康人进行口服葡萄糖耐量试验、胰岛素和C肽释放试验，并应用多普勒超声心动图仪探测急性心肌梗塞患者左心室收缩和舒张功能。结果发现左心室射血分数＜0.50的患者（LEF组）、左心室射血分数＞0．50的患者（NEF分数）和正常组空腹血糖浓度接近，而空腹胰岛素水平却LEF组＞NEF组＞正常组，胰岛素敏感性指数三组依次增大；LEF、NEF两组糖耐量受损与异常增高的胰岛素释放反应并存，LEF组胰岛素释放反应强度大于NEF组；某些收缩功能参数（主要是左心室射血分数）与多个胰岛素抵抗参数显著相关。提示急性心肌梗塞恢复期患者左心室收缩功能受损与胰岛素抵抗程度相关联。

Relationship between Heart Function and Insulin Resistance in Patients with Acute Myocardial Infarction

Aim: Researching the relationship between heart function and insulin resistance (IR) in acute myocardial infarction (AMI).Methods: The study included 20 healthy subjects and 26 AMI patients. Oral glucose tolerance test,insulin and Cpeptide release tests were conducted in all subjects. All the patients underwent Doppler echocardiography by which left ventricular systolic and diastolic functional parameters were determined.The subjects were divided into three groups, that is,LEF group (the patients having ejection fraction (EF) <0.05), NEF group(the patients having EF > 0. 05) and normal group.Results: Fasting blood glucose levels were not significantly different among the three groups, whereas fasting insulin levels were increased in order of the groups. In LEF and NEF groups, impaired glucose tolerance coexisted with exceptional strong insulin response to glucose load. and the response in LEF group was stronger than that in NEF group. EF and some other systolic functional parameters were significantly correlated with many of IR parameters.Conclusion: The impaired left ventricular systolic function in AMI patients might be associated with the severity of IR.