窦晓林,袁平,毛宗雯,杨倩,姚旗,蒋梅英,孙农
DOU Xiao-lin; YUAN Ping; MAO Zong-wen; YANG Qian; YAO Qi; JANG Mei-ying; SUN Nong (ICU;

• 1:贵阳市第四人民医院ICU
• 2:贵阳市第四人民医院ICU
• 3:贵阳市第四人民医院ICU
• 4:贵阳市第四人民医院ICU

摘要(Abstract)：

目的 :探讨危重病患者是否存在高胰岛素血症、胰岛素抵抗 (IR)及与肿瘤坏死因子 (TNF α)、白细胞介素 6 (IL 6 )的关系。方法 :测定危重病患者 12 3例和对照组 30例的空腹血糖 (FBG)、空腹胰岛素 (FINS)、TNF α、IL 6的水平 ,并计算胰岛素敏感性指数 (IAI) ,以评估危重病患者IR的严重程度 ,并分析各参数之间的相关性。结果 :危重病组与对照组的IAI分别为 - 1 95± 0 38和 - 1 5± 0 2 9,两者差异显著 (P <0 0 1)。危重病按病因分组后各组IAI相比无显著差异 (P >0 0 5 )。IAI与危重病严重程度、TNF α及IL 6的直线回归分析 ,直线关系r分别为 0 86 ,- 0 89,- 0 87,差异有显著性 (P <0 0 1)。结论 :危重病患者存在高胰岛素血症及IR。IR的程度与危重病程度、TNF α、IL 6的水平有显著相关性。危重病患者的IR与TNF α的升高有关 ,提示IAI可作为危重病患者病情严重程度的预测指标。
Objective: To explore the relation of serum insulin level with cytokine content in patients of critical diseases. Methods: FBG, FINS, TNF-α and IL-6 were measured in patient groups with different pathogenesis (SD, 123 cases) and control group (CO, 30 cases). The degree of insulin resistance(IR)was assessed by calculating IAI, and the relations between these indices were assayed. Results: IAI between SD groups (-1.95±0.38) and CO group (-1.57±0.29) were significantly different. IAI among the patient groups were not different (P>0.05). IAI was significantly correlated with the severity, TNF-α and IL-6. The “r”s were 0.86, -0.89, and -0.87 respectively which were significantly different (P<0.01). Conclusion: IR and hyperinsulinaemia occur in patients with critical diseases. The degree of IR was significantly correlated with degree of severity, TNF-α and IL-6. It could be used as an index to indicate the severity of the disease.

关键词(KeyWords)： 危重病;胰岛素;细胞因子类;胰岛素抵抗
critical illness; insulin; cytokines; insulin resistance

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 窦晓林,袁平,毛宗雯,杨倩,姚旗,蒋梅英,孙农
DOU Xiao-lin; YUAN Ping; MAO Zong-wen; YANG Qian; YAO Qi; JANG Mei-ying; SUN Nong (ICU;

DOI: 10.19367/j.cnki.1000-2707.2003.06.012

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