| Coronary atherosclerotic heart disease and the coronary artery function changes are known together as Coronary heart disease, to be abbreviated as CHD. The dangerous factor of CHD apart from the tradition 's dangerous factors, during the formation and development process of atheromatous, the metabolism disorder syndrome rise a can t be neglect role, among them insulin resistance(IR) is a key factor . IR is the physiology effect of normal concentration insulin is lower than normal, for regulating the blood sugar in the normal level, organic secrete the excessive insulin for compensation, so cause a series of pathologic physiology changes , which cause occurrence and development of various metabolism disease. IR and its closely - related metabolism disorder, such as the high blood pressure, 2 - diabetes, abnormality of lipid metabolism all become the main cause of CHD, but IR may rise the predominant function. In the IR examination methods the sensitive gold standard is a normal blood sugar clamp technique of high insulin, the next in order is a small model method of Bergman, but these measurement methods are more complicacy, and cant be applied in the epidemiology study, the variety insulin sensitivity that is indicated as the empirical formula, which is in common use are HOMA Model 20 FIns/( FPG -3.5) and I/ Fins x FPG is in brief easy line, so can be applied in clinical and big sample research.Along with the change of medical model, many research suggest that the mental state factor is relatived to the development and occurrence of CHD. The mental social factors activate the mechanism of nervours_endocrine with bad behavior method and living habit, activate sympathetic and blood platelets activity, cause the function damage of coronary endothelium , atheromatous plaque, coronary spasm, urge the coronary narrow, myocardial isocheimal, cause heart vascular disease. For evaluation of mental state the 90 item of symptom checklist ( SCL - 90) , used to reflect the mental disorder and body disease patients mental state, suitable for evaluation of mental state of psycho-neurosis , adjustment disorder and other non mental illness, reflect the influence of mental factor to patients body symptom.But the interaction effect between IR and mental social factor has not been definite valuated. This experiment studied the effect of IR and mental state factor to CHD, and analyzed the affect mutually between IR and mental state factor.Investigate methodsThe object is CHD group 50 pou, matching the standard of diagnosis and assigning name of isocheims heart disease established by WHO , average age 60. 70 ±9. 67Y. Normal matched control group 50 pou, all are healthy checkers, apart from heart - vascular disease, diabetes et al, average age 60. 06±7. 08Y. All the objects are fasting for 12 hours, and adopt the morning fasting elbow vein blood 5 ml. Use full - automatic biochemical analysis machine to measurement the serum glyceryl trioleate ( TG) , cholesterol ( Ch) , apoprotein A1 (apoA1) , apoproteinB ( apoB ) , glucose content ( FBG) . Adopting the radio - immunity analysis method to measurement the insulin con-tent (Fins). And calculate: Insulin sensitivity index number( ISI) = I/(Fins x FBG); The insulin resists (HOMA - IR) = Fins x FBG/22.5; B cell function (HOMA- B cell) =20 x FIns/( FBG -3.5).All objects are evaluated the mental state factor with the SCL -90. All data were expressed as mean value standard deviation. Statistics analysis was done using SPSS software. Comparison between two groups was tested by Student Newman - Keuls t test. When P <0. 05 were considered to be significant.Investigate resultCompare with normal matched control group, and the CHD group increased markedly in TG, apoA1, apoB; FBG make no difference, marked discrepancy in Fins, ISI, HOMA - IR, HOMA - B cell compare with the normal matched control group. In CHD group the symptoms of the somatization dimension, the depression dimension, the anxiety dimension, the phobic anxiety dimension, the diet and sleep dimens... |
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