摘要
目的 研究烧伤小鼠 2 4h内胰岛素及胰岛素敏感性的时相变化特点 ,初步探讨安定 -氯胺酮麻醉对创伤后胰岛素抵抗的影响。方法 将 90只BALB/C小鼠随机分为正常对照组、麻醉对照组、烧伤组、预处理组 (麻醉后 15min烧伤 )及后处理组 (烧伤后 15min麻醉 )。烧伤组给予背部Ⅲ度 15 %～ 2 0 %烧伤 ,伤后 2、4、6、12、2 4h采血 ;麻醉对照组、预处理组及后处理组均采用安定和氯胺酮麻醉 ,烧伤或麻醉后 4h采血。测定血糖水平 ,采用放免法测定血清胰岛素。结果 烧伤组血糖、胰岛素明显升高 ,其中血糖 2～ 4h达到高峰 ,以后逐渐下降 ,而血清胰岛素 6～ 12h达到高峰 ,至 2 4h仍显著高于正常对照组 ,烧伤组各时相点胰岛素敏感指数均显著低于正常对照组 ,其中 4h最低 ,以后逐渐恢复 ;预处理组、后处理组血糖和胰岛素显著高于正常对照组 ,但比烧伤组 4h明显低 ,而后处理组显著高于预处理组 ;同样发现 ,预处理组胰岛素敏感指数显著高于后处理组 ,但均比正常对照组低 ,比烧伤组 4h高。结论 严重烧伤后早期产生明显的胰岛素抵抗 ,血糖和胰岛素均明显升高 ,而胰岛素敏感性显著降低 ;安定 -氯胺酮麻醉预处理对其具有抑制作用 ,甚至烧伤后给予也有一定作用。
Objective To observe the development insulin resistance and study the effect of diazepam-ketamine anesthesia on it in burned mice.Methods 80 BALB/C male mice were divided randomly into five groups:control,anesthesia control,burn,pretreatment and posttreatment.Burn group produced 15%～20% thickness third degree burn injury.Anesthesia control group received only diazepam-ketamine anesthesia. Pretreatment or posttreatment group receive diazepam-ketamine anesthesia 15 min before or after burn injury.The concentrations of blood glucose and plasma insulin were detected in burn group during 24 h after burn,and detected in anesthesia control,pretreatment and posttreatment group at 4 h after burn or anesthesia.Results After burn injury,the concentrations of blood glucose and plasma insulin increased markedly compared with control group.Blood glucose peaked at 2～4 h postburn and plasma insulin peaked at 6～12 h postburn.Insulin sensitivity index was obviously decreased after burn injury and reached its nadir at 4 h postburn,it did not come back to the normal level at 24 h.The level of blood glucose and plasma insulin in pretreatment and posttreatment group increased markedly compared with control group,but was obviously lower than that in burn control group at 4 h.The blood glucose and plasma insulin in posttreatment group were obviously higher than those in pretreatment group.The insulin sensitivity index in the pretreatment and posttreatment group was markedly decreased compared with control group,while it was obviously higher in the pretreatment group than in the posttreatment group.Conclusion These results indicate that burn injury induces profound hyperinsulinemia in combination with significant hyperglycemia,suggesting the development of insulin resistance with impaired insulin sensitivity.Diazepam-ketamine anesthesia exerts suppression on the response,even find the effect of diazepam-ketamine when it was used after burn injury.
出处
《中国急救医学》
CAS
CSCD
北大核心
2004年第3期169-170,共2页
Chinese Journal of Critical Care Medicine
基金
国家重点基础研究发展规划项目 ("973"项目 ) (G19990 5 42 0 0 )
关键词
烧伤
胰岛素抵抗
安定
氯胺酮
Burn
Insulin resistance(IR)
Diazepam
Ketamine
