Abstract: ［Abstract］ Objective〖HTSS〗〓To investigate the relationship between plasma plateletactivating factoracetylhydrolase(PAFAH ) and insulin resistance, glucose and lipid metabolism in elderly patients with ischemic stroke.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 100 elderly patients with ischemic stroke were selected. The homeostasis model assessment insulin resistance(HOMAIR) index was calculated based on the patients′ blood glucose and insulin levels. Fifty cases were included in the IR group and 50 cases were in the nonIR group. In the same period, 30 older people with normal physical examination  were selected as normal control group. Fasting blood glucose, fasting insulin, HOMAIR, and triglycerides(TG) levels were compared among the three groups. The activity of PAFAH under different binding states in each group of patients was compared. The PAFAH activity of different combinations of patients in each group was compared. The activity ratio of LPAFAH/HPAFAH activity and the characteristics of glucose lipid metabolism and clinical data were compared, and the correlation analysis was conducted. 
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The average fasting blood glucose, fasting insulin, HOMAIR and TG levels in IR group were significantly higher than those in nonIR group and control group(P＜005). The levels of low density lipoprotein cholesterol(LDLC）and total cholesterol(TC) in the IR group were higher than those in the control group(P＜005). The levels of  fasting blood glucose, fasting insulin, LDLC, TC and TG in nonIR group were higher than those in control group(P＜005). The plasma LPAFAH, PAFAH activity and LPAFAH/HPAFAH activity ratio in IR group were higher than those in nonIR group and control group(P＜005). The Pearson correlation analysis found that plasma LPAFAH/HPAFAH activity ratio were positively correlated with HOMAIR, fasting blood glucose, fasting insulin, TG,LDLC,TC level and aortic sclerosis in all patients(r=0.654, 0.597, 0.532, 0.442, 0.612, 0.336, 0.466, P＜005). There was a negative correlation with HDLC(r=-0.571, P＜005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The increase of plasma PAFAH, LPAFAH and LPAFAH/HPAFAH ratio in patients with ischemic stroke may be associated with IR, atherosclerosis, chronic inflammation and oxidative stress in human body, which is a risk factor for ischemic stroke patients. The LPAFAH/HPAFAH activity ratio may be a monitoring indicator of chronic inflammatory state in patients with ischemic stroke with IR or arteriosclerosis.

Key words: strok, plateletactivating factoracetylhydrolase, insulin resistance