全身炎症反应综合征患者胰岛素强化治疗对血清炎症介质的影响  

Effect of intensive insulin therapy on serum proinflammatory cytokine levels in patients with systemic inflammatory response syndrome

作　　者：王弋[1] 许国根[1] 吴锦鸿[1] 赵雪[1] 缪群[1] 陈雯[1] 

机构地区：[1]杭州市第一人民医院急诊科,浙江杭州310016

出　　处：《全科医学临床与教育》2007年第1期36-38,共3页Clinical Education of General Practice

摘　　要：目的研究全身炎症反应综合征患者(SIRS)施行胰岛素强化治疗对体内肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)等早期炎症介质的影响。方法68例发生应激性高血糖(血糖超过9.00mmol/L)的SIRS患者,配对后随机分为胰岛素强化治疗组和常规治疗组,分别在治疗前和治疗后第1、2和3天抽取肘静脉血3ml,采用酶联免疫吸附法(ELISA)测定血浆TNF-α与IL-6水平,并测定C-反应蛋白(CRP)变化以评估炎症程度。结果胰岛素强化治疗显著降低了SIRS患者血清TNF-αI、L-6和CRP水平,与常规治疗组比较差异有显著性,(P<0.05或P<0.01)。结论胰岛素强化治疗可拮抗SIRS患者高炎症状态,抗炎效应可能是除降血糖、促合成代谢作用之外胰岛素强化治疗又一改善SIRS患者预后的重要机制。Objective To investigate the effect of intensive insulin therapy on serum levels of tumor necrosis factor- α （TNF - α ）, interleukin - 6（IL- 6） and C reaction protein （CRP）, all of which reflected the inflammatory status in patients with systemic inflammatory response syndrome（SIRS） . Methods 68 patients diagnosed as SIRS were randomly divided into intensive insulin therapy group and control group. 3 ml blood was drawn from elbow vein in each patient respectively on before therapy and 1st, 2nd and 3rd days＇ morning after their therapy . Enzyme - linked immunoadsorbent assay （ELISA） method was used to determine TNF - α, IL - 6 and CRP serum levels. Result serum levels of TNF - α, IL - 6 and CRP in patients received intensive insulin therapy were significantly lower than those in patients without the therapy（ P 〈 0.05 or P 〈 0.01 ） Conclusion Intensive insulin therapy can attenuate the systemic inflammatory response to SIRS. The anti - inflammatory actions of insulin, as well as its glycemia controlling effects, might contribute to the improved outcomes of patients with SIRS .

关 键 词：全身炎症反应综合征 胰岛素强化治疗 肿瘤坏死因子-α 白细胞介素-6 C反应蛋白 

分 类 号：R459.7[医药卫生—急诊医学]