极化液个体化治疗对创伤后高血糖病人促/抗炎细胞因子的影响  

The effects of individual treatment of GIK on the pro-and anti-inflammatory cytokines of patients with Trauma

作　　者：王占科[1] 雷万生[1] 汪仕良[2] 陈范昶[1] 于永洲[1] 李光伟[3] 许霖水[4] 陈自力[1] 钱锁开 刘庆志[1] 

机构地区：[1]解放军第九四医院创伤研究室,江西南昌330002 [2]第三军医大学西南医院烧伤研究所,重庆400038 [3]卫生部中日友好医院内分泌科,北京100029 [4]第三军医大学生物化学与分子生物学教研室,重庆400038

出　　处：《肠外与肠内营养》2007年第5期275-278,共4页Parenteral & Enteral Nutrition

基　　金：江西省卫生厅资助课题(20052044);南京军区医药卫生"十一五"重大课题资助(06Z25);南京军区卫生专业人才培养"122工程"资助项目

摘　　要：目的:探讨极化液个体化治疗对创伤后高血糖病人促/抗炎细胞因子以及多器官功能障碍综合征(MODS)的影响,为极化液辅助治疗创伤后MODS提供实验依据。方法:将我院重症监护室收治的创伤后高血糖病人,随机分为极化液个体化治疗组(G IK组)和基础治疗组(C组)。观察不同治疗组治疗3 d后创伤病人空腹血糖、乳酸、促炎细胞因子(CRP、TNF-α和IL-1β)和抗炎细胞因子(IL-4和IL-10)水平变化以及MODS的发生率和病死率。结果:GIK组治疗3 d后,空腹血糖、乳酸、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-1β(IL-1β)水平均明显低于C组,血IL-4和IL-10水平明显高于C组。GIK组MODS的发生率明显低于C组,MODS病死率虽略有下降,但与C组比无显著差异。结论:极化液个体化治疗创伤后病人可降低促炎细胞因子和升高抗炎细胞因子水平,对控制创伤后病人的高血糖效果明显。Objective： To study the effects of individual treatment of GIK（Glucose-Insulin-Potassium） on the pro-and antiinflammatory cytokines and the risk of MODS caused by trauma.Methods： The trauma patients with hyperglycemia in ICU of our hospital,were randomly divided to the GIK group and routine group.The levels of the fasting glucose,lactic acid,pro-inflammatory cytokines（CRP,TNFα,IL-1β） and anti-inflammatory cytokines（IL-4,IL-10）,the percentage of MODS and the mortality of MODS were observed in the GIK and routine groups.Results： The levels of the glucose,lactic acid,CRP,TNF-α,IL-1β in GIK groups were lower significantly than that in C groups.The levels of IL-4,IL-10 in GIK groups were higher significantly than that in C groups.The percentage of MODS in GIK group was lower significantly than that in C group.Conclusion： The individual treatment of GIK can contribute to the cure and prevention of MODS caused by trauma by reducing pro-inflammatory cytokines increasing anti-inflammatory cytokines,supplying glucose and ameliorating the abnormal glucose metabolism.

关 键 词：多器官功能障碍综合征 个体化治疗 促炎细胞因子 抗炎细胞因子 

分 类 号：R641[医药卫生—外科学]