摘要
目的:探讨危重病人高血糖反应与炎性细胞因子及预后的关系。方法:选择65例危重病人,在入院24小时内测定空腹血糖、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平,随机分成胰岛素治疗组和常规治疗组,追踪观察1个月后疗效。结果:危重病人血糖、TNF-α、IL-6含量明显升高,与正常对照组比较差异有显著性意义(P<0.01,P<0.001);与APACHEⅡ计分、预后显著相关(P<0.01);血糖含量与TNF-α、IL-6水平呈显著正相关(r=0.6256,r=0.5674);用胰岛素治疗组与常规治疗组预后无显著性差异(P>0.05)。结论:对危重病人高血糖反应的处理应采取综合措施,因此拮抗TNF-α、IL-6等炎症因子,提高胰岛素的敏感性是治疗危重病人高血糖反应的关键。
Purpose: To investigate the relationship between response ot high blood glucose and inflammatory cytokines, and prognosis in critical patients. Methods: 65 patients with serious disease were selected, blood glucose,tumor necrosis fac-tor-α( TNF-α) and interleukin-6( IL-6) were measured within 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. Results: The level of blood glucose, TNF-a and IL-6 of patients group increased obviously, and was significantly different from that of control group( P <0. 01, P <0. 001) ,and was significantly related to APACHE II and prognosis( P <0. 01 ). The content of blood glucose was significantly positive correlation to TNF-α and IL-6( r =0. 6256, r =0. 5674) No significant difference was found between the prognosis of insulin treatment group and the conventional treatment group(P>0. 05 ) . Conclusion: The general measures must be adopted to treat patients with serious disease. So resisting the inflammatory cytokine including TNF-α, IL-6 and so on and increasing insulin sensitivity was the key measurement to treat response of high blood glucose in patients with serious disease.
出处
《临床急诊杂志》
CAS
2003年第5期5-7,共3页
Journal of Clinical Emergency
