摘要
目的探讨危重患者高血糖反应与炎症细胞因子及预后的关系。方法选择65例危重患者,随机分为胰岛素治疗组和常规治疗组,在入院24h内测定空腹血糖、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平,追踪观察1个月后的疗效。结果危重患者血糖、TNF-α、IL-6水平明显升高,与正常对照组比较差异有统计学意义(P<0.01或P<0.001),与APACHEⅡ评分、预后相关(P<0.01);血糖与TNF-α、IL-6水平呈正相关(r=0.6256、0.5674);胰岛素治疗组与常规治疗组预后比较差异无统计学意义(P>0.05)。结论拮抗TNF-α、IL-6等炎症因子,提高胰岛素的敏感性是治疗危重患者高血糖反应的关键。
Objective To investigate the relationship between the response of hyperglycemia and inflammatory cytokines, prognosis in the patients with serious disease. Method 65 patients with serious disease were selected, blood glucose, tumor necrosis factor -α（ TNF-α） and interleukin - 6 （ IL - 6） were measured in 24 hours after hospitalization. Patients were randomly divided into the insulin treatment group and the conventional treatment group, the clinical effect was observed in one month .after treatment. Result The level of blood glucose, TNF -αand IL - 6 of patients group increased obviously. There was significant difference in comparison with control group（ P 〈0. 01, P 〈0. 001）. There was significant correlation with APACHE Ⅱ and prognosis（ P 〈 0.01）. The content of blood glucose correlated positively with TNF-α and IL - 6 （ r = 0. 6256,0, 5674 ）. No significant difference was found between the prognosis of insulin treatment group and the conventional treatment group （ P 〉 0. 05）. Conclusion To antagonise the inflammatory cytokine including TNF-α, IL - 6 and so on and to improve insulin sensitivity was key measure to treat the hyperglycemia in the patients with serious disease.
出处
《中国急救医学》
CAS
CSCD
北大核心
2007年第6期498-500,共3页
Chinese Journal of Critical Care Medicine
关键词
危重患者
高血糖
炎症细胞因子
预后
Patients with serious disease
Hyperglycemia
Inflammatory cytokine
Prognosis
