摘要：目的：探讨胰岛素抵抗(IR)及脂质代谢与冠心病(Coronary heart disease，CHD)发生发展的相关性及临床意义。方法：回顾性分析经冠状动脉造影确诊的冠心病患者68例，其中包括不稳定型心绞痛(UA)患者24例，稳定型心绞痛(SA)32例，心肌梗塞(AMI)12例；正常对照组35例的空腹血脂(血清甘油三酯TG、血总胆固醇TC、高密度脂蛋白胆固醇HDL-C、低密度脂蛋白胆固醇LDL-C、载脂蛋白ApoA1及ApoB)、空腹血糖(FBG)、空腹胰岛素(FINS)、糖负荷后胰岛素曲线下面积(RIAUC)及葡萄糖曲线下面积(GAUC)的变化并进行比较。结果：冠心病组的TC、LDL-C及ApoB水平较正常对照组明显升高，而HDL-C及ApoA1/ApoB则显著降低，差异有统计学意义(P<0.05)；同时冠心病组FINS/FBG、RIAUC、GAUC以及RIAUC/GAUC较对照组均显著增加，差异有统计学意义(P<0.01～0.05)。结论：冠心病存在胰岛素抵抗、高胰岛素血症及脂质代谢的异常，它们都是冠心病发生的危险因素，胰岛素抵抗与冠心病临床症状的严重程度相关。

    关键词：冠心病；胰岛素抵抗；血脂

    Clinical Study on Insulin Resistance and Lipide Metabolize in Patients with Coronary Heart Disease

    WANG Cui-xia，JIE Yu-li,CHEN Ling

    (The Affiliated Hospital of Guangdong Medical College,Guangdong Zhanjiang 524001,China)

    Abstract：Objective：To investigate the relativity and clinical significance of insulin resistance (IR) and lipide metabolize in patients with coronary heart disease (CHD). Method: Retrospectivly analyse the coronary heart disease, 68 patients diagnosed the coronary angiography, including Unstable Angina (UA) the 24 patients, Stable Angina (SA) 32 patients, myocardial infarction (AMI) 12 patients; Compares the change of normal comparison group 35 patients fasting blood lipide:Trighycerides (TG), Total Cholesterol (TC), High Density Lipoprotein Cholesterol (HDL-C), Low Density Lipoprotein Cholesterol (LDL-C), Apolipoproteins (ApoA1 and ApoB), Fasting Blood Glucose (FBG), Fasting Insulin (FINS), Insulin area under curve (RIAUC) and Glucose area under curve (GAUC). Result: The levels of TC, LDL-C and the ApoB in coronary heart disease group was more obviously elevated than normal comparison group ......