中文摘要：

目的探讨痰瘀型代谢综合征（MS）及合并冠心病（CHD）病人血清脂联素和胰岛素抵抗（IR）的关系。方法酶联免疫吸附法测定痰瘀型单纯MS病人（16例）、MS合并CHD病人（17例）、健康对照者（14名）的脂联素和空腹血清胰岛素水平;计算胰岛素抵抗指数（HOMA-IR）;收集MS合并CHD病人冠脉造影数据,计算Gensini积分。结果脂联素：MS组为（15.47±8.06）μg/mL和MS合并CHD组为（12.75±3.74）μg/mL,均显著低于健康对照组的（28.40±26.19）μg/mL,有统计学意义（P〈0.01）。HOMA-IR分别为1.75±0.98、1.60±0.89,均显著高于健康对照组的1.02±0.15,有统计学意义（P〈0.05）。脂联素与高血压呈负相关;HOMA-IR与糖尿病、高血压病呈正相关。以脂联素为因变量,显示性别、高血压病、高密度脂蛋白（HDL-C）与脂联素具有相关性。以Gensini积分为应变量的多元逐步线性回归分析提示,Gensini积分与脂联素相关（r 2=0.520,P=0.038）。结论痰瘀型MS合并CHD病人脂联素水平明显降低,且与冠脉狭窄程度明显相关,提示MS和CHD均存在IR,脂联素降低所引起的胰岛素抵抗加重了AS进展,在MS发展为CHD中起到了一定作用,而脂联素的水平可反映胰岛素抵抗和冠心病病情的严重程度,有一定的疾病诊断、预测价值。

英文摘要：

Objective To investigate the relationship between the levels of adiponectin and insulin resistance （IR）in patients with phlegm and blood stasis type of metabolic syndrome （MS）combined with coronary heart disease （CHD）.Methods Levels of serum adiponectin and insulin were measured by enzyme linked immunosorbent assay （ELISA）in phlegm and blood stasis type of 16 MS patients,17 MS＋CHD patients,and 14 healthy controls.Other information on the conventional clinical features of MS,such as waist circumference and fasting blood levels of glucose and fat,was col ected,and homeostatic model assessment （HOMA） IR values were calculated.At the same time,coronary angiography data were col ected,and Gensini scores were calculated in CHD patients. Statistical analyses,such as Pearson correlation and regression analysis,were used in this study. Results There were significant differences in adiponectin among healthy controls （28.40μg/mL± 26.19μg/mL）,patients with MS （15.47μg/mL± 8.06μg/mL）,and patients with MS＋CHD （12.75μg/mL± 3.74μg/mL）.There were significant differences in HOMA IR among healthy controls （1.02± 0.152）,patients with MS （1.75± 0.98）,and patients with MS＋CHD （1.60± 0.89）.Pearson correlation analyses suggested that adi-ponectin was associated with gender;the level in women was less than in men.Furthermore,adiponectin was negatively correlated with hypertension.HOMA IR was positively correlated with diabetes,hypertension,and HS CRP.Logistic regression analysis indica-ted a statistical y significant relationship between adiponectin and gender,hypertension and HDL c,and Gensini score and adipone-ctin. Conclusion The levels of adiponectin were clearly decreased in patients with phlegm and blood stasis type of MS and lower in patients with MS＋CHD,which were significantly correlated with the degree of coronary artery stenosis.This indicated that IR existed in both MS and CHD,and IR caused by the reduction of adiponectin might promote the progress of atheroscler