烧伤后胰岛素抵抗的实验研究  

Insulin resistance following thermal injury: an animal study

作　　者：陈新龙[1] 夏照帆[1] 韦多[1] 田建广[1] 郇京宁[1] 路卫[1] 唐洪泰[1] 朱世辉[1] 

机构地区：[1]第二军医大学长海医院烧伤科,上海200433

出　　处：《第二军医大学学报》2004年第10期1049-1051,共3页Academic Journal of Second Military Medical University

基　　金：国家自然科学基金 ( 3 0 2 713 40 ) ;国家重点基础研究规划 ("973"计划 )课题 ( G19990 5 43 0 9) ;国家高新技术发展规划("863"计划 )课题 ( 2 0 0 1AA2 160 4)

摘　　要：目的 :探讨大鼠烧伤后葡萄糖耐量 ,胰岛素敏感性指数和正常血糖高胰岛素钳夹的变化情况 ,证实烧伤后存在胰岛素抵抗。方法 :6周龄 SD大鼠 (体质量 16 0～ 170 g)随机分为假烫伤组和烫伤组 ,每组 8只。烫伤组大鼠制成烧伤面积为 30 %的 度烫伤模型 ,伤后第 3天禁食 12 h后采血 ,用自动血糖仪测定血糖 ;用大鼠胰岛素 EL ISA试剂盒测血浆胰岛素水平和胰岛素敏感性指数 (ISI) ;测 0、30、6 0、90、12 0 min血糖值 ,观察葡萄糖耐量的变化 ;伤后第 4天观察正常血糖高胰岛素葡萄糖钳夹技术 10 %葡萄糖总输注率的变化情况。 结果 :与假烫伤组相比 ,大鼠烫伤后第 3天血糖和血浆胰岛素水平显著升高 [血糖(8.94± 2 .2 2 ) vs(6 .10± 0 .6 2 ) m mol/L,血浆胰岛素浓度 (3.14± 1.0 8) vs(1.0 6± 0 .4 5 ) ng/ml,P<0 .0 1],而 ISI显著下降[(0 .5 8± 0 .2 3) vs(1.2 3± 0 .16 ) ,P<0 .0 1]。烫伤后第 3天葡萄糖耐量实验显示烫伤大鼠对于外源性葡萄糖耐受性在各时间点均明显降低。烫伤后第 4天正常血糖高胰岛素钳夹技术检测显示 10 %葡萄糖输注率较假烫伤组显著下降 [(7.2 3± 1.35 ) vs(12 .31± 0 .5 4 ) mg/(kg· m in) ,P<0 .0 1]。 结论 :大鼠烧伤后可引起糖代谢异常并导致胰岛素抵抗发生。Objective:To investigate the changes of glucose tolerance,insulin sensitivity index and Euglycemic-Hyperinsulinemic glucose clamps after burn in rats,further confirming the existence of insulin resistance following thermal injury. Methods: Sprague-Dawley rats, weighing 160-170 g,were randomized into burn group and control group(n=8). The animals in burn group received 30% total burn surface area(TBSA) full thickness burn injury. After 12 h overnight fasting,plasma insulin concentration and blood glucose were assayed and insulin sensitivity index was calculated 3 d after burn.The rats were injected with 5% glucose(2 g/kg, i.p.) to observe the change of glucose tolerance 3 d after burn. Euglycemic-Hyperinsulinemic Glucose Clamps was performed 4 d after burn. Results: The levels of plasma insulin and blood glucose elevated significantly,and insulin sensitivity index reduced significantly 3 d after burn(0.58±0.23 vs 1.23±0.16,P<0.01).Significant difference of glucose tolerance was observed between the 2 groups and the glucose infused rate[mg/(kg·min)] in burned rats was significantly decreased compared with that in control group 4 d after injury(7.23±1.35 vs 12.31±0.54,P<0.01). Conclusion: Burn causes significant change of glucose metabolism and results in insulin resistance in rats.

关 键 词：烧伤 胰岛素抵抗 葡萄糖耐量 胰岛素敏感性指数 正常血糖高胰岛素钳夹 

分 类 号：R644[医药卫生—外科学]