摘要
目的:探讨早期胰岛素强化治疗对脓毒症患者血管内皮细胞功能的修复及保护作用。方法:选取ICU住院治疗脓毒症患者74例,随机分为常规组和强化组。两组均给予常规对症治疗。在此基础上,常规组常规给予胰岛素治疗,控制血糖在10.0~11.1 mmol·L^(-1);强化组将胰岛素加入微量泵持续泵入,使血糖控制在6.6~8.3 mmol·L^(-1)间。观察并记录两组治疗前与治疗7 d后血清血管性假血友病因子(vWF)、血栓调节蛋白(TM)和内皮细胞特异性分子1(ESM-1)的变化情况,评估其临床效果及药品不良反应。结果:治疗7 d后,两组血清vWF、TM和ESM-1指标均较前明显下降(P<0.01或P<0.05),且强化组下降较常规组更明显(P<0.05);同时强化组临床总有效率明显高于常规组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:早期胰岛素强化治疗脓毒症的疗效确切,可降低血清vWF、TM和ESM-1等指标,修复及保护血管内皮功能。
Objective： To explore the effect of recovery and protection on the function of vascular endothelial cells of early intensive insulin therapy in sepsis patients. Methods： 74 sepsis patients in the department of ICU were chosen and randomly divided into routine group and strengthened group. Both of the two groups were given conventional symptomatic treatment. On this basis,routine group were received insulin injection,and maintenanced of blood glucose at a level 10. 0-11. 1 mmol·L-（-1）. Strengthened group were received continuous pumped insulin injection,and maintenanced of blood glucose at a level 6. 6-8. 3 mmol·L-（-1）. The changes of serum vWF,TM,ESM-1 indexes before and after seven days treatment were observe and record,and the clinical effect and adverse drug reaction were evaluated. Results： The serum vWF,TM and ESM-1 indexes in the two groups were remarkably decresed after seven days treatment（ P〈0. 01 or P〈0. 05）,and the strengthened group decresed significantly than routine group（ P〈0. 05）. The clinical efficiency of strengthened group was significantly higher than that of routine group（ P〈0. 05）. Compared the adverse drug reaction of two groups,there was no statistically significant difference（ P〈0. 05）. Conclusion： Early intensive insulin therapy in sepsis patients had sure efficacy,which could reduces serum vWF,TM,ESM-1 indexes,and repair and protect the function of vascular endothelial cells.
出处
《药物流行病学杂志》
CAS
2017年第1期7-9,共3页
Chinese Journal of Pharmacoepidemiology
关键词
脓毒症
胰岛素
强化治疗
血管内皮细胞
Sepsis
Insulin
Intensive therapy
Vascular endothelial cells
