中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
17期
45-47
,共3页
心脏瓣膜置换术%胰岛素抵抗%瘦素
心髒瓣膜置換術%胰島素牴抗%瘦素
심장판막치환술%이도소저항%수소
Cardiac valve replacement%Insulin-resistance%Leptin
目的 探讨心脏瓣膜置换术围术期胰岛素抵抗发生与瘦素的关系.方法 20例心脏瓣膜置换术患者分别于麻醉前及术后2、12、24、48 h采集血样,测定瘦素、胰岛素、血糖和红细胞压积,计算稳态胰岛素抵抗指数(HOMA-IR)、胰岛素敏感性指数[1/(G×INS)]和胰岛素血糖比值(I/G).结果 胰岛素、血糖和HOMA-IR在麻醉开始后显著升高,与麻醉前相比差异有统计学意义(P<0.05);1/(G×INS)与麻醉前相比显著下降,差异有统计学意义(P<0.05);术后2h瘦素与麻醉前相比显著下降,差异有统计学意义(P<0.05),术后24 h时逐步上升达到峰值(P<0.01).瘦素与HOMA-IR呈显著的正相关(r=0.958,P=0.010).结论 在心脏瓣膜置换术围术期机体出现强烈的胰岛素抵抗,瘦素在心脏瓣膜置换术围术期IR的发生、发展中可能发挥重要的作用.
目的 探討心髒瓣膜置換術圍術期胰島素牴抗髮生與瘦素的關繫.方法 20例心髒瓣膜置換術患者分彆于痳醉前及術後2、12、24、48 h採集血樣,測定瘦素、胰島素、血糖和紅細胞壓積,計算穩態胰島素牴抗指數(HOMA-IR)、胰島素敏感性指數[1/(G×INS)]和胰島素血糖比值(I/G).結果 胰島素、血糖和HOMA-IR在痳醉開始後顯著升高,與痳醉前相比差異有統計學意義(P<0.05);1/(G×INS)與痳醉前相比顯著下降,差異有統計學意義(P<0.05);術後2h瘦素與痳醉前相比顯著下降,差異有統計學意義(P<0.05),術後24 h時逐步上升達到峰值(P<0.01).瘦素與HOMA-IR呈顯著的正相關(r=0.958,P=0.010).結論 在心髒瓣膜置換術圍術期機體齣現彊烈的胰島素牴抗,瘦素在心髒瓣膜置換術圍術期IR的髮生、髮展中可能髮揮重要的作用.
목적 탐토심장판막치환술위술기이도소저항발생여수소적관계.방법 20례심장판막치환술환자분별우마취전급술후2、12、24、48 h채집혈양,측정수소、이도소、혈당화홍세포압적,계산은태이도소저항지수(HOMA-IR)、이도소민감성지수[1/(G×INS)]화이도소혈당비치(I/G).결과 이도소、혈당화HOMA-IR재마취개시후현저승고,여마취전상비차이유통계학의의(P<0.05);1/(G×INS)여마취전상비현저하강,차이유통계학의의(P<0.05);술후2h수소여마취전상비현저하강,차이유통계학의의(P<0.05),술후24 h시축보상승체도봉치(P<0.01).수소여HOMA-IR정현저적정상관(r=0.958,P=0.010).결론 재심장판막치환술위술기궤체출현강렬적이도소저항,수소재심장판막치환술위술기IR적발생、발전중가능발휘중요적작용.
Objective To investigate the relationship between insulin resistance and leptin in the perioperation of cardiac valve replacement.Methods Twenty patients were treated with cardiac valve replacement.Blood samples were obtained at the following intervals:before anesthesia,2 h,12 h,24 h and 48 h after cardiac valve replacement.The concentrations of leptin,insulin,hematokrit and blood glucose were measured.The insulin-resistance index (HOMA-IR),insulin-sensitivity index [1/ (INS × G)] and the ratio of insulin to blood glucose (I/G) were obtained.Results Insulin,blood glucose and HOMA-IR increased significantly from the beginning of anesthesia and went to the peak at 24 h after cardiac valve replacement (P < 0.05).1/(INS × G) decreased significantly after anesthesia (P < 0.05).Leptin level decreased gradually at the beginning and increased rapidly to the peak at 24 h after operation (P < 0.01).HOMA-IR correlated well with leptin (r =0.958,P =0.010).Conclusions Insulin resistance exists in the perioperation of cardiac valve replacement.Correlation between leptin and insulin-resistance index indicates the role of leptin in insulin-resistance.