摘要
[目的]探讨呼吸衰竭患者体内血浆内皮素(endothelin,ET)水平与胰岛素抵抗(insulin resistance,IR)水平的关系,并分析两者对预后判断的价值。[方法]随机选取50例在我院ICU确诊为呼吸衰竭的患者及同期50例健康体检者组成实验组和对照组。实验组的50例患者根据机械通气(mechanical ventilation,MV)治疗结果分为存活组(22例)、死亡组(13例)和剔除组(15例)3个亚组(剔除组的15例患者在2周末未死亡但拔管不成功而改为气管切开继续MV,因其2周末治疗结果未知,故予以剔除)。各组分别于特定时间点检测IR指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-IS)、血浆ET水平,并考察存活组和死亡组的血浆ET水平及HOMA-IR的动态变化。[结果]与对照组比较,实验组的ET值和HOMAIR值明显升高并且两者之间成正相关(r=0.336,P<0.05);存活组机械通气过程中ET值和HOMA-IR值呈连续下降趋势,在病程各时间点的测得值经单因素方差分析有显著性差异(P<0.01),而死亡组机械通气过程中该两指标均无明显下降趋势,在病程各时间点的测得值经单因素方差分析无显著性差异(P>0.05)。[结论]呼吸衰竭患者存在着显著的IR和血浆ET水平增高,并且两者之间成正相关。HOMA-IR及ET水平之动态变化与呼吸衰竭机械通气患者的预后密切相关,观察这类患者机械通气治疗期间血浆ET水平和HOMA-IR的动态变化情况有助于判断其预后。
[Objective] The paper aimed to investigate the relationship between plasma endothelin（ET） level and insulin resistance level in patients with respiratory dysfunction and evaluate its prognosis value.[Methods] 50 patients who were diagnosed as respiratory dysfunction and 50 healthy patients were selected and respectively divided into the experimental group and the control group.35 patients from the experimental group were divided into 2 subgroups-survival group（22 patients） and death group（13 patients） and the others 15 patients were excluded.We measured the HOMA-IR（meaninginsulin resistance level）,HOMA-IS（meaning the secretory function of β cell） and plasma endothelin level of the experimental group and control group and then examined the dynamic changes of plasma ET and HOMA-IR in patients of survival group and death group.[Results] Plasma endothelin level and insulin resistance level（HOMA-IR） in patients of the experimental group were higher compared with subjects of the control group.Plasma endothelin level had a positive correlation with insulin resistance level in patients of the experimental group（r=0.336,P〈0.05）.There was a downward trend in plasma ET level and HOMA-IR of patients in the survival group after mechanical ventilation,and there showed significant differences in the value of plasma ET and HOMA-IR in different phases of mechanical ventilation,which was tested by ANOVA.However,there was no significant downward trend in the plasma ET level and HOMA-IR in patients of death group after mechanical ventilation,and the value of plasma ET and HOMA-IR did not show significantly differences in different phases of mechanical ventilation,which was tested by ANOVA.[Conclusion] Patients with respiratory dysfunction had a high level of plasma ET and insulin resistance,and the two values were positively correlated.The dynamic changes of plasma ET and insulin resistance level were closely correlated with the prognosis of the patients who underwent mechanical ventilation for respiratory dysfunction.To investigate the dynamic changes of plasma ET and insulin resistance level in these patients was helpful to judge the prognosis of them.
出处
《浙江中医药大学学报》
CAS
2014年第9期1066-1069,共4页
Journal of Zhejiang Chinese Medical University
基金
浙江省卫生厅资助项目(2013KYA144)~~
关键词
ET
IR
呼吸衰竭
预后
endothelin
insulin resistance
respiratory dysfunction
prognosis
