摘要：目的：探讨Ⅱ型糖尿病(DM)患者胰岛素抵抗(IR)与冠心病的关系。方法：临床观察A组：40例合并冠心病的Ⅱ型DM患者；B组：50例临床排除了冠心病的Ⅱ型DM患者。测定血糖、糖化血红蛋白(HbA1c)、血脂、胰岛素，并计算IR、胰岛素敏感指数(ISI)。结果：A组与B组HbA1c、甘油三酯(TG)、HOMA-IR、ISI值比较有非常显著性意义(p<0.01),A组与B组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)值比较也有显著性意义(p<0.05)。多元逐步回归分析结果示：在a=0.05水平进入回归方程的因素有FINS、BMI、TC，有统计学意义。结论：IR、血脂、HbA1c与冠心病的发生有明显相关性，改善胰岛素抵抗，纠正脂代谢，糖代谢紊乱能达到有效地防治冠心病的目的。

    关键词：胰岛素抵抗；冠心病；Ⅱ型糖尿病

    Relationship between Coronary Heart Disease and Insulin Resistance in type Ⅱ DM

    HAN Jing，WANG Jian，JIANG Xia

    (First Central Hospital, Tianjin 300192, China)

    Abstract： Objective: To study the relationship between coronary and insulin resistance in type Ⅱ DM patients. Method: A group: 40 T2 DM patients with coronary heat disease; B group: 50 T2 DM patients without coronary heart disease. The levels of glucose, HbA1c, TC, TG, LDL-C, HDL-C, INS, were measured in 90 cases with T2 DM, and IR, ISI were calculated. Result: There was significant effect with HbA1c, TG, HOMA-IR, ISI (p<0.01) in 2 groups’ patients. There were effected with TC, LDL-C, HDL-C (p<0.05) in 2 groups’ patients. In the group of T2 DM with coronary heart disease, a multiple stepwise regression analysis indicated that FINS, BMI, TC were independent factors that affect HOMA-IR. Conclusion: IR, HbA1c, TG, TC, HDL-C, LDL-C were related with coronary heart disease. ......