胰岛素强化治疗对重度充血性心力衰竭高血糖患者血清炎症介质水平及氧代谢的影响  

Effects of intensive insulin therapy on inflammatory mediators and oxygen metabolism in the patients with severe congestive heart failure and hyperglycemia

作　　者：谭辉[1] 张振美[1] 刘娅[1] 商德亚[1] 

机构地区：[1]山东省立医院急救中心,济南250021

出　　处：《中国急救医学》2007年第9期773-775,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨有效控制血糖对重度充血性心力衰竭(CHF)心功能及预后的影响。方法CHF并高血糖患者168例随机分为治疗组(84例)和对照组(84例),观察肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、动脉血气分析、血糖、血乳酸及心脏指数(CI)的变化。结果治疗组心功能、TNF-α、CRP、pH、PaCO2、PaO2、血糖、血乳酸、CI与对照组比较差异均有统计学意义(P<0.05,P<0.01)。结论胰岛素强化治疗明显改善重度CHF的心功能及预后,机制可能与降低重度CHF的炎症介质、改善氧代谢有关。Objective To observe the changes of inflammatory mediators and oxygen metabolism in the patients with severe congestive heart failure（ CHF） and hyperglycemia after intensive insulin therapy, and to discuss the effects on heart function and prognosis by controlling blood sugar. Methods 168 patients with severe CHF and hyperglycemia were enrolled in the study. They were divided into two groups ： treatment group （ 84 cases ） and control group （ 84 cases ）. The changes of heart function, TNF - α, CRP, pH, PaCO2, PaO2, blood sugar, blood lactic acid and cardiac index （CI） were observed. Restilts There were significant differences in the above mentioned parameters in two groups. Conclusion Intensive insulin therapy obviously improve heart function and prognosis of patients with severe CHF by controlling blood sugar, and the mechanisms may correlate with the decrease of inflammatory mediators and improvement of oxygen metabolism.

关 键 词：胰岛素强化治疗 高血糖 心力衰竭 充血性 炎症因子 氧代谢 

分 类 号：R541.6[医药卫生—心血管疾病]