目的 探讨miR-93表达与甲状腺腺瘤（TA）手术应激胰岛素抵抗（EIR）患者的关联性。方法 采用氧化酶法检测32例TA合并EIR（实验组）患者总胆固醇（TC）、三酰甘油（TG）、空腹血糖（FBG）和空腹血清胰岛素（FINS），用qRT-PCR检测miR-93表达水平，并与32例单纯TA组（对照组）和30例健康体检者（健康组）进行比较。结果 实验组TC、TG、FBG、FINS和miR-93水平分别为（6.4±0.6）mmol/L、（2.4±1.0）mmol/L、（6.3±0.5）mmol/L、（36.2±12.6）MIU/L和1.83±0.61；对照组分别为（6.3±0.6）mmol/L、（1.9±1.0）mmol/L、（6.0±0.5）mmol/L、（20.5±10.3）MIU/L和2.95±0.49；健康组分别为（5.1±0.7）mmol/L、（1.4±0.7）mmol/L、（5.1±0.6）mmol/L、（17.7±9.1）MIU/L和3.44±0.42。实验组和对照组患者治疗前miR-93表达水平分别为1.82±0.62和2.93±0.49，实验组TG、FBG和FINS水平高于对照组（P<0.01）和健康组（P<0.01），实验组miR-93水平低于对照组（P<0.01）和健康组（P<0.01）；2组患者治疗前后miR-93表达水平差异无统计学意义（P>0.05），miR-93表达水平与TC、TG、FBG和FINS呈负相关。结论 miR-93在TA患者呈低表达，在EIR患者也呈低表达，miR-93表达水平与TC、TG、FBG和FINS呈负相关；miR-93作为保护性因素而不是致病因素参与TA手术EIR的发生和发展。

Objective To investigate the correlation between the expression level of miR-93 and surgical excitability of insulin resistance (EIR) of patients with thyroid adenoma (TA). Methods The total cholesterol (TC), triglyceride (TG), fasting blood glucose (FBG), and fasting serum insulin (FINS) of 32 cases of TA combined with EIR (experiment group), 32 cases of pure TA (control group), and 30 cases of healthy people (health group) were detected by the oxidase method and the expression level of miR-93 was detected by the qRT-PCR. The results of three groups were compared. Results TC, TG, FBG, FINS, and miR-93 level of the experiment group were (6.4±0.6) mmol/L, (2.4±1.0) mmol/L, (6.3±0.5) mmol/L, (36.2±12.6) MIU/L, and 1.83±0.61; those of the control group were (6.3±0.6) mmol/L, (1.9±1.0) mmol/L, (6.0±0.5) mmol/L, (20.5±10.3) MIU/L, and 2.95±0.49; those of the health group were (5.1±0.7) mmol/L, (1.4±0.7) mmol/L, (5.1±0.6) mmol/L, (17.7±9.1) MIU/L, and 3.44±0.42, respectively. Expression levels of miR-93 of the experiment group and control group were 1.82±0.62 and 2.93±0.49 before treatment. Levels of TG, FBG, and FINS of the experiment group were higher than those of the control group (P<0.01) and health group (P<0.01). The miR-93 level of the experiment group was lower than that of the control group (P<0.01) and health group (P<0.01). The differences of the expression level of miR-93 of the experiment group and control group before and after treatment were not statistically significant (P>0.05). The expression level of miR-93 was negatively correlated with TC, TG, FBG, and FINS. Conclusion The expression of miR-93 of TA patients and TA patients with EIR is low. The expression level of miR-93 is negatively correlated with TC, TG, FBG, and FINS. The miR-93 involve in the occurrence and development of surgical EIR of patients with TA as a protective factor, rather than a pathogenic factor.