中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2015年
18期
1391-1394
,共4页
危重症%高血糖%细胞因子信号传导抑制蛋白-3%胰岛素样生长因子结合蛋白-1
危重癥%高血糖%細胞因子信號傳導抑製蛋白-3%胰島素樣生長因子結閤蛋白-1
위중증%고혈당%세포인자신호전도억제단백-3%이도소양생장인자결합단백-1
Critical illness%Hyperglycemia%Suppressors of cytokine signaling-3%Insulin-like growth factor binding protein-1
目的：探讨危重患儿血清细胞因子信号传导抑制蛋白-3( SOCS-3)、胰岛素样生长因子结合蛋白-1( IGFBP-1)水平及其与高血糖发生的关系。方法选择2009年1月至2012年1月广州市妇女儿童医疗中心儿童重症监护室( PICU)治疗的脓毒症患儿、先天性心脏病体外循环修补术后患儿及严重外伤术后患儿共64例为研究对象,根据入院时血糖情况分为血糖正常组和血糖增高组,选择同期广州市妇女儿童医疗中心体检健康儿童15例为健康对照组,检测并比较各组血糖、胰岛素、血清SOCS-3、IGFBP-1水平以及胰岛素抵抗指数(HOMA-IR)。结果1.血糖增高组的血糖[(9.83±2.48) mmol/L]显著高于血糖正常组[(4.82±0.76) mmol/L]和健康对照组[(4.49±0.81) mmol/L](P<0.05)；2.与血糖正常组、健康对照组相比,血糖增高组胰岛素水平、HOMA-IR显著增高[9.68(5.85,17.35) mU/L比4.08(2.00,7.41) mU/L、2.83(2.00,10.10) mU/L；4.30(2.70,7.66)比0.87(0.39,1.94)、0.52(0.38,2.56)](P<0.05)；3.健康对照组、血糖正常组、血糖增高组3组间的血清IGFBP-1及SOCS-3水平差异均无统计学意义(P>0.05)；4.危重患儿血糖与胰岛素、HOMA-IR 呈正相关(r=0.455、0.773,P<0.05),而血糖、胰岛素、HOMA-IR与SOCS-3、IGFBP-1间均无相关性(P>0.05)。结论儿童危重症高血糖发生与胰岛素抵抗密切相关,同时不支持血清IGFBP-1、SOCS-3水平变化作为评估危重患儿发生胰岛素抵抗继而引起高血糖的指征。此外,不排除危重患儿同时存在胰岛素抵抗和胰岛β细胞功能障碍。
目的：探討危重患兒血清細胞因子信號傳導抑製蛋白-3( SOCS-3)、胰島素樣生長因子結閤蛋白-1( IGFBP-1)水平及其與高血糖髮生的關繫。方法選擇2009年1月至2012年1月廣州市婦女兒童醫療中心兒童重癥鑑護室( PICU)治療的膿毒癥患兒、先天性心髒病體外循環脩補術後患兒及嚴重外傷術後患兒共64例為研究對象,根據入院時血糖情況分為血糖正常組和血糖增高組,選擇同期廣州市婦女兒童醫療中心體檢健康兒童15例為健康對照組,檢測併比較各組血糖、胰島素、血清SOCS-3、IGFBP-1水平以及胰島素牴抗指數(HOMA-IR)。結果1.血糖增高組的血糖[(9.83±2.48) mmol/L]顯著高于血糖正常組[(4.82±0.76) mmol/L]和健康對照組[(4.49±0.81) mmol/L](P<0.05)；2.與血糖正常組、健康對照組相比,血糖增高組胰島素水平、HOMA-IR顯著增高[9.68(5.85,17.35) mU/L比4.08(2.00,7.41) mU/L、2.83(2.00,10.10) mU/L；4.30(2.70,7.66)比0.87(0.39,1.94)、0.52(0.38,2.56)](P<0.05)；3.健康對照組、血糖正常組、血糖增高組3組間的血清IGFBP-1及SOCS-3水平差異均無統計學意義(P>0.05)；4.危重患兒血糖與胰島素、HOMA-IR 呈正相關(r=0.455、0.773,P<0.05),而血糖、胰島素、HOMA-IR與SOCS-3、IGFBP-1間均無相關性(P>0.05)。結論兒童危重癥高血糖髮生與胰島素牴抗密切相關,同時不支持血清IGFBP-1、SOCS-3水平變化作為評估危重患兒髮生胰島素牴抗繼而引起高血糖的指徵。此外,不排除危重患兒同時存在胰島素牴抗和胰島β細胞功能障礙。
목적：탐토위중환인혈청세포인자신호전도억제단백-3( SOCS-3)、이도소양생장인자결합단백-1( IGFBP-1)수평급기여고혈당발생적관계。방법선택2009년1월지2012년1월엄주시부녀인동의료중심인동중증감호실( PICU)치료적농독증환인、선천성심장병체외순배수보술후환인급엄중외상술후환인공64례위연구대상,근거입원시혈당정황분위혈당정상조화혈당증고조,선택동기엄주시부녀인동의료중심체검건강인동15례위건강대조조,검측병비교각조혈당、이도소、혈청SOCS-3、IGFBP-1수평이급이도소저항지수(HOMA-IR)。결과1.혈당증고조적혈당[(9.83±2.48) mmol/L]현저고우혈당정상조[(4.82±0.76) mmol/L]화건강대조조[(4.49±0.81) mmol/L](P<0.05)；2.여혈당정상조、건강대조조상비,혈당증고조이도소수평、HOMA-IR현저증고[9.68(5.85,17.35) mU/L비4.08(2.00,7.41) mU/L、2.83(2.00,10.10) mU/L；4.30(2.70,7.66)비0.87(0.39,1.94)、0.52(0.38,2.56)](P<0.05)；3.건강대조조、혈당정상조、혈당증고조3조간적혈청IGFBP-1급SOCS-3수평차이균무통계학의의(P>0.05)；4.위중환인혈당여이도소、HOMA-IR 정정상관(r=0.455、0.773,P<0.05),이혈당、이도소、HOMA-IR여SOCS-3、IGFBP-1간균무상관성(P>0.05)。결론인동위중증고혈당발생여이도소저항밀절상관,동시불지지혈청IGFBP-1、SOCS-3수평변화작위평고위중환인발생이도소저항계이인기고혈당적지정。차외,불배제위중환인동시존재이도소저항화이도β세포공능장애。
Objective To investigate the relationship among serum levels of suppressors of cytokine signaling-3(SOCS-3),insulin-like growth factor binding protein-1(IGFBP-1) and hyperglycemia in critically ill children. Methods The 64 critically ill children who suffered from sepsis,after surgical repair of congenital heart dis-ease by extracorporeal circulation, and after surgery of severe traumatic from January 2009 to January 2012 in Depart-ment of Pediatric Intensive Care Unit( PICU) of Guangzhou Women and Children′s Medical Center were selected as the research object. According to the blood glucose levels on admission, the 64 children were divided into the normal glu-cose group and the hyperglycemia group. The 15 cases of healthy children in the same period in Guangzhou Women and Children′s Medical Center were selected as the healthy control group. The levels of blood glucose,insulin,SOCS-3,IG-FBP-1 and insulin resistance index( HOMA-IR) were measured and compared among groups when they were on ad-mission. Results (1) The blood glucose of the hyperglycemia group was significantly higher than those in the normal glucose group and the healthy control group[(9. 83±2. 48) mmol/L vs (4. 82±0. 76) mmol/L,(4. 49±0. 81) mmol/L] (P<0. 05). (2) Both of the insulin and HOMA-IR in critically ill children with hyperglycemia were significantly higher than those in the other 2 groups[9. 68(5. 85,17. 35) mU/L vs 4. 08(2. 00,7. 41) mU/L,2. 83(2. 00,10. 10) mU/L;4. 30(2. 70,7. 66) vs 0. 87(0. 39,1. 94),0. 52(0. 38,2. 56)](P<0. 05). (3) The serum SOCS-3,IGFBP-1 levels among the hyperglycemia group,the normal glucose group and the healthy control group were not of significant difference (P>0. 05). (4) The blood glucose was positively correlated with the insulin and HOMA-IR(r=0. 455,0. 773,P<0. 05),but there was no significant correlation among the blood glucose,insulin,HOMA-IR,SOCS-3 and IGFBP-1(P>0. 05). Con-clusions In the critically ill children,hyperglycemia was related to the insulin resistance which can not be evaluated through changes in serum levels of SOCS-3 and IGFBP-1. In addition,it cannot be excluded that the critically ill chil-dren may have insulin resistance and pancreaticβ-cell dysfunction simultaneously.
