中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2010年
25期
12-14
,共3页
胰岛素%危重病%C反应蛋白质%白细胞介素6%肿瘤坏死因子α
胰島素%危重病%C反應蛋白質%白細胞介素6%腫瘤壞死因子α
이도소%위중병%C반응단백질%백세포개소6%종류배사인자α
Insulin%Critical illness%C-reactive protein%Interleukin-6%Tumor necrosis factor-alpha
目的 观察胰岛素强化治疗对危重病合并高血糖患者外周血非特异炎性因子C反应蛋白(CRP)、白细胞介素6(IL6)及肿瘤坏死因子α(TNF-α)水平的影响及不良反应的发生率.方法 将209例危重病合并高血糖患者按随机数字表法分为胰岛素强化治疗组(106例,静脉血糖控制在4.4～6.1 mmol/L)和胰岛素常规治疗组(103例,静脉血糖控制在9.0～11.1 mmol/L).分别于转入ICU即刻及治疗后24、48、72 h检测并比较两组血清CRP、IL-6、TNF-α水平.结果 两组血糖水平均达到目标控制,低血糖发生率胰岛素强化治疗组为6.60%(7/106),与胰岛素常规治疗组的4.76%(3/63)比较差异无统计学意义(P>0.05).治疗后72 h,胰岛素强化治疗组血清CRP水平明显低于胰岛素常规治疗组(P<0.05);治疗后24、48、72 h,胰岛素强化治疗组血清IL-6水平均明显低于胰岛素常规治疗组(P<0.05);治疗后48、72 h,胰岛素强化治疗组血清TNF-α水平亦明显低于胰岛素常规治疗组(P<0.05).结论 胰岛素强化治疗可以降低危重病合并高血糖患者外周血非特异炎性因子的水平,有益于病情恢复.
目的 觀察胰島素彊化治療對危重病閤併高血糖患者外週血非特異炎性因子C反應蛋白(CRP)、白細胞介素6(IL6)及腫瘤壞死因子α(TNF-α)水平的影響及不良反應的髮生率.方法 將209例危重病閤併高血糖患者按隨機數字錶法分為胰島素彊化治療組(106例,靜脈血糖控製在4.4～6.1 mmol/L)和胰島素常規治療組(103例,靜脈血糖控製在9.0～11.1 mmol/L).分彆于轉入ICU即刻及治療後24、48、72 h檢測併比較兩組血清CRP、IL-6、TNF-α水平.結果 兩組血糖水平均達到目標控製,低血糖髮生率胰島素彊化治療組為6.60%(7/106),與胰島素常規治療組的4.76%(3/63)比較差異無統計學意義(P>0.05).治療後72 h,胰島素彊化治療組血清CRP水平明顯低于胰島素常規治療組(P<0.05);治療後24、48、72 h,胰島素彊化治療組血清IL-6水平均明顯低于胰島素常規治療組(P<0.05);治療後48、72 h,胰島素彊化治療組血清TNF-α水平亦明顯低于胰島素常規治療組(P<0.05).結論 胰島素彊化治療可以降低危重病閤併高血糖患者外週血非特異炎性因子的水平,有益于病情恢複.
목적 관찰이도소강화치료대위중병합병고혈당환자외주혈비특이염성인자C반응단백(CRP)、백세포개소6(IL6)급종류배사인자α(TNF-α)수평적영향급불량반응적발생솔.방법 장209례위중병합병고혈당환자안수궤수자표법분위이도소강화치료조(106례,정맥혈당공제재4.4～6.1 mmol/L)화이도소상규치료조(103례,정맥혈당공제재9.0～11.1 mmol/L).분별우전입ICU즉각급치료후24、48、72 h검측병비교량조혈청CRP、IL-6、TNF-α수평.결과 량조혈당수평균체도목표공제,저혈당발생솔이도소강화치료조위6.60%(7/106),여이도소상규치료조적4.76%(3/63)비교차이무통계학의의(P>0.05).치료후72 h,이도소강화치료조혈청CRP수평명현저우이도소상규치료조(P<0.05);치료후24、48、72 h,이도소강화치료조혈청IL-6수평균명현저우이도소상규치료조(P<0.05);치료후48、72 h,이도소강화치료조혈청TNF-α수평역명현저우이도소상규치료조(P<0.05).결론 이도소강화치료가이강저위중병합병고혈당환자외주혈비특이염성인자적수평,유익우병정회복.
Objective To observe the effects of intensive insulin therapy on C-reactive protein (CRP) ,interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α ) in the patients of critical illness complicated with hyperglycemia and its incidence of side effect. Methods Two hundred and nine patients of critical illness complicated with hyperglycemia were randomly divided into intensive insulin therapy group (106 patients,blood glucose maintained at a level of 4.4-6.1 mmol/L) and conventional insulin therapy group ( 103 patients, blood glucose maintained at a level of 9.0-11.1 mmol/L). Serum levels of CRP,TNF- α and IL-6 were determined on 0,24,48,72 h respectively after ICU admission. Results The levels of blood glucose of both groups reached the target level. The incidence rates of the hypoglycemia had no significant difference between two groups [6.60 % (7/106) vs. 4.76% ( 3/63 ),P > 0.05]. After 72 h treatment, serum level of CRP in intensive insulin therapy group was significantly lower than that in conventional insulin therapy group (P < 0.05 ). After 24,48 and 72 h treatment, serum level of IL-6 in intensive insulin therapy group was significantly lower than that in conventional insulin therapy group (P < 0.05 ). After 48 and 72 h treatment, serum level of TNF-αin intensive insulin therapy group was significantly lower than that in conventional insulin therapy group (P < 0.05). Conclusion Intensive insulin therapy can significantly decrease the levels of non-specific inflammatory factors in patients of critical illness complicated with hyperglycemia, which brings beneficial effect to the patients.
