GIK液在围体外循环期机体高胰岛素伴高血糖状态中的应用  

Effect of GIK treatment in patients with high insulin and blood glucose during cardiopulmonary bypass

作　　者：郑奇军[1] 程晓东[2] 俞世强[1] 陈文生[1] 崔勤[1] 金振晓[1] 高峰[3] 

机构地区：[1]第四军医大学西京医院心脏外科,陕西西安710032 [2]第四军医大学西京医院检验科,陕西西安710032 [3]第四军医大学基础部生理学教研室,陕西西安710032

出　　处：《心脏杂志》2007年第1期76-78,共3页Chinese Heart Journal

基　　金：国家自然科学基金项目资助(No.30471923)

摘　　要：目的研究极化液(GIK)对体外循环后高胰岛素伴高血糖状态引起的内分泌和代谢紊乱的防治作用。方法选取32例单个瓣膜置换术患者,分别在麻醉前、体外循环前、体外循环30 min、开放升主动脉10 min和停体外循环后30 min抽取血样,测定血糖、胰岛素、C肽、生长激素和皮质醇等,进行动态对比分析。实验分GIK治疗组和空白对照组。结果体外循环期间血糖、胰岛素、C肽、生长激素和皮质醇等与麻醉前比较均有不同程度增高(P<0.05);同时,GIK组血糖、生长激素和皮质醇浓度显著低于对照组(P<0.05),而胰岛素、C肽浓度显著高于对照组(P<0.05)。结论体外循环可导致机体胰岛素和血糖升高,GIK治疗可以有效防治体外循环后高胰岛素伴高血糖状态引起的内分泌和代谢紊乱。AIM To investigate the preventive and therapeutic effects of GIK solution on high state of insulin and blood glucose, hormones and metabolic disorder in patients during cardiopulmonary bypass （CPB）. METHODS Thirty-two patients to be treated with single-valve replacement operations were divided into 2 groups： GIK group （n = 16） and control group （n = 16 ）. GIK solution containing insulin （G/I = 1：1 ） was infused continuously at a rate of 16.67 nkat/（ kg h） into the patients in GIK group, and GIK withiut insulin was infused to the patients in control group from induction of anesthesia to clamping of aortic flow. Blood samples were obtained respectively from patients of the two groups before anesthesia, before CPB, 30 min after CPB and 10 min after de-clamping of aortic. Insulin, c-peptide, corti- sol, growth hormone as well as blood glucose were also measured. RESULTS During the period of cardiopulmonary bypass, glucose, insulin, C-peptide, glucagons, cortisol and growth hormone all significantly increased （P 〈 0.05 ）. In comparison with those of control group, the levels of blood glucose, cortisol and growth hormone were significantly reduced（ P 〈0.05 ）and the levels of c-peptide and insulin increased（ P 〈 0.05 ） in GIK group. CONCLUSION Cardiopulmonary bypass leads to a typical peripheral high state of insulin and blood glucose. GIK Solution can increase the insulin sensitivity and improve hormones and metabolic disorder in patients with high insulin and blood glucose.

关 键 词：极化液 体外循环 胰岛素 

分 类 号：R654.2[医药卫生—外科学]