摘要
目的观察应激状态时，危重症患儿血糖水平变化与疾病危重程度、免疫反应性胰岛素（IRI）水平、血清真胰岛素（TI）水平变化的关系。方法在PICU病房及呼吸科普通病房选取58例患儿入组，分别为PICU组（42例）及普通组（16例）。PICU组患儿根据血糖检测结果分为高血糖组（20例）及非高血糖组（22例），并进行小儿危重评分。所有人选患儿检测血清IRI、TI、C肽及血糖。结果高血糖组患儿入院时危重评分[（74．80±8．07）分]明显低于非高血糖组[（84．36±9．46）分]，差异有统计学意义（t=1．964，P〈0．05）。且高血糖组病死率（45．0％，9／20例）明显高于非高血糖组（13．6％，3／22例），差异有统计学意义（χ2=5．05，P〈0．05）。入院时高血糖组患儿血清IRI、TI、C肽均显著高于非高血糖组及普通组，差异有统计学意义（F=136．90、61．25、45．89，P均〈0．05）。入院时高血糖组患儿TI／IRI显著低于非高血糖组及普通组，差异有统计学意义（F=27．64，P〈0．05）。高血糖组患儿入院48hTI、c肽及TI／IRI值较入院时显著降低，差异有统计学意义（t=2．241、2．087、2．014，P均〈0．05）。结论危重症患儿存在应激性高血糖及血清胰岛素组分的变化，血清TI绝对水平和比例下降。
Objective To study the relationships between the level of blood glucose in critical ill children with the degree of critical illness and the variation of immunoreactive insulin （IRI） and true insulin（TI）. Methods Fifty- eight children form the Neonatal Intensive Care Unit （PICU） and Department of Respiration were enrolled in this study. The children were divided into PICU group （42 cases） and control group （ 16 cases）. The PICU group were scored pediatric critical score in 24 hours after admission. Tile 42 critical ill children were divided into stress hypergly- cemia group （20 cases ） and non-stress hyperglycemia group （22 cases） according to their blood glucose levels. The IRI ,TI, C-Peptide and blood glucose were measured. Results The pediatric critical illness score of stress hyperglyce- mia group [ （74.80 ± 8.07 ） scores ] was significantly lower than that of non-stress hyperglycemia group [ （ 84.36 ± 9.46） scores] （ t = 1. 964 ,P 〈 0.05 ） . The death rate of stress hyperglycemia group （ 45.0% ,9/20 cases） was signifi- cantly higher than that of non-stress hyperglycemia group （13.6% , 3/22 cases） （χ2 = 5.05, P 〈 0.05 ）. The IRI, TI and C-Peptide of stress hyperglycemia group were significantly higher than those of non-stress hyperglycemia group and control group（ F = 136.90,61.25,45.89 ,all P 〈0.05 ）. The TI/IRI of stress hyperglycemia group was signifieandy lower than that of non-stress hyperglycemia group and control group （ F = 27.64 ,P 〈 0.05 ）. The TI, IRI and C-Peptide of stress hyperglycemia group were higher than after admission （ t = 2. 241,2. 087,2. 014, all P 〈 0.05 ）. Conclusions The children with critical illness have stress hyperglycemia and the component of insulin is changed, and the absolute level as well as the rate of TI and TI/IRI are descended.
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2014年第6期416-418,共3页
Chinese Journal of Applied Clinical Pediatrics
