多器官功能不全综合征患者胰岛素抵抗及胰岛素受体密度和亲和力变化的研究  

The insulin resistance and the changes of density and affinity of insulin receptor on erythrocytes surface in MODS patients

作　　者：李树生[1] 杨博[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院急诊科,武汉430030

出　　处：《临床内科杂志》2006年第5期325-327,共3页Journal of Clinical Internal Medicine

摘　　要：目的探讨多器官功能不全综合征(MODS)患者胰岛素抵抗(IR)与红细胞表面胰岛素受体密度和亲和力的变化。方法应用葡萄糖氧化酶法测定MODS患者空腹血糖(FBG),放射免疫法测定胰岛素,放射受体分析法测定受体密度及亲和力。结果MODS各组患者空腹血糖、胰岛素、胰岛素抵抗指数(HOMA-IR)均明显高于对照组(P<0.01),且MODS死亡组明显高于生存组(P<0.01);MODS各组胰岛素分泌指数(HOMA-β)明显低于对照组,且MODS死亡组明显低于生存组。MODS各组患者红细胞表面胰岛素受体密度及亲和常数较对照组显著减少(P<0.01),而MODS死亡组亲和常数较生存组显著减少(P<0.01),受体密度比较无显著性差异(P>0.05)。结论MODS患者存在IR且与预后相关,红细胞膜胰岛素高亲和力受体减少可能是MODS患者发生IR的机制之一。Objective To elucidate the role of insulin resistance and the changes of density and affinity of insulin receptor on erythrocytes surface in patients with multiorgan dysfunction syndrome （MODS）. Method Fasting blood glucose was detected by glucose oxidase method, insulin was determined by radioimmunoassay. The density and afiqnity of insulin receptor on erythrocytes surface were determined by the radioreceptor assay in MODS patients. Results The levels of fasting blood glucose,insulin, HOMA - IR in MODS patients were significant higher than those in the controls. The density and affinity of insulin receptor on erythrocytes surface in MODS patients were significantly lower than those in the controls. Conclusion The estimation of index of HOMA - IR and HOMA β would contribute to the diagnosis of MODS. Down-regulation of insulin receptors might be a key mechanism which the MODS patients developed insulin resistance.

关 键 词：多器官功能不全综合征 胰岛素抵抗 胰岛素受体 

分 类 号：R459.7[医药卫生—急诊医学] R587[医药卫生—治疗学]