CAJ | 학술논문

目的：探讨脓毒症患儿血清胰岛素样生长因子-I(IGF-I)和血糖的变化及相关意义。方法选择2009年1月至2010年1月入住PICU的脓毒症患儿42例，检测入院次日清晨血糖和血清IGF-I、皮质醇、胰岛素、IL-6、IGF结合蛋白-I(IGFBP-I)及入院第3、5天晨血清IGF-I水平，根据入院次日血糖水平分为血糖升高组和血糖正常组；以同期健康体检儿童60例为对照组，分别比较三组间各指标的差异。结果入院次日，脓毒症血糖升高组、血糖正常组和对照组三组间血糖、IGF-I、皮质醇、胰岛素、IL-6水平的差异有统计学意义(P均<0.001)，而IGFBP-I水平差异无统计学意义(P>0.05)。两两比较发现，与对照组相比，脓毒症血糖升高组和血糖正常组患儿的皮质醇、IL-6显著升高，IGF-I显著降低，差异有统计学意义(P均<0.05)；血糖升高组的血糖和胰岛素水平均高于血糖正常组和对照组，差异有统计学意义(P均<0.05)。脓毒症血糖正常及血糖升高组患儿IGF-I水平随时间变化(入院次日，第3、5天)的差异无统计学意义(P均>0.05)；在入院次日，第3、第5天，两组脓毒症患儿之间IGF-I水平的差异也无统计学意义(P均>0.05)。入院次日，脓毒症患儿血糖与IGF-I水平无明显相关性(r=0.152，P=0.267)。结论脓毒症患儿IGF-I降低，并在病程中保持稳定，血糖变化与IGF-I无显著联系。
목적：탐토농독증환인혈청이도소양생장인자-I(IGF-I)화혈당적변화급상관의의。방법선택2009년1월지2010년1월입주PICU적농독증환인42례，검측입원차일청신혈당화혈청IGF-I、피질순、이도소、IL-6、IGF결합단백-I(IGFBP-I)급입원제3、5천신혈청IGF-I수평，근거입원차일혈당수평분위혈당승고조화혈당정상조；이동기건강체검인동60례위대조조，분별비교삼조간각지표적차이。결과입원차일，농독증혈당승고조、혈당정상조화대조조삼조간혈당、IGF-I、피질순、이도소、IL-6수평적차이유통계학의의(P균<0.001)，이IGFBP-I수평차이무통계학의의(P>0.05)。량량비교발현，여대조조상비，농독증혈당승고조화혈당정상조환인적피질순、IL-6현저승고，IGF-I현저강저，차이유통계학의의(P균<0.05)；혈당승고조적혈당화이도소수평균고우혈당정상조화대조조，차이유통계학의의(P균<0.05)。농독증혈당정상급혈당승고조환인IGF-I수평수시간변화(입원차일，제3、5천)적차이무통계학의의(P균>0.05)；재입원차일，제3、제5천，량조농독증환인지간IGF-I수평적차이야무통계학의의(P균>0.05)。입원차일，농독증환인혈당여IGF-I수평무명현상관성(r=0.152，P=0.267)。결론농독증환인IGF-I강저，병재병정중보지은정，혈당변화여IGF-I무현저련계。
Objective To explore the variation of insulin like growth factor-I (IGF-I) and glucose and correlation in children with sepsis. Methods Forty-two children with sepsis in pediatric intense care unit were enrolled from January 2009 to January 2010. In the morning (2nd morning) after admission, the blood glucose, serum IGF-I, cortisol, insulin, IL-6, and IGF-binding protein-I (IGFBP-1) were detected. In the 3rd and 5th morning, the serum IGF-1 was detected again. According to the blood glucose level of the 2nd morning, the children with sepsis were divided into hyperglycemia group and normal group. Meanwhile, 60 healthy children were served as control group. The data had been compared among three groups. Results In the 2nd morning, the levels of blood glucose, serum IGF-I, cortisol, insulin, and IL-6 were signiifcantly different among three groups (all P<0.05), but the serum IGFBP-I was not signiifcantly different (P>0.05). Compared with control group, the sepsis children with hyperglycemia and with normal blood glucose all had signiifcantly higher serum levels of cortisol and IL-6, and signiifcantly lower serum level of IGF-I. In the 2nd, 3rd, and 5th morning, the serum levels of IGF-1 were not signiifcantly changed with time in sepsis children with hyperglycemia and with normal blood glucose (all P>0.05). Meanwhile, there were no signiifcant differ-ences in the serum levels of IGF-1 between sepsis children with hyperglycemia and with normal blood glucose in the 2nd, 3rd, and 5th morning (all P>0.05). In children with sepsis, the blood glucose and serum IGF-1 was not correlated in the next morning (r=0.152, P=0.267). Conclusions The serum level of IGF-I decreased but maintain stable in children with sepsis. The change of blood glucose may be not related with IGF-I.