胰岛素强化治疗对体外循环术后外周血IL-10浓度及单核细胞核因子-κB活性的影响  

Effects of intensive insulin therapy on IL-10 level and NF-ΚB activity in patients undergoing cardiopulmonary bypass

作　　者：杨文东[1] 魏崴[1] 黄东[1] 钟标[1] 

机构地区：[1]惠州市中心人民医院心胸外科,广东省惠州516001

出　　处：《中国基层医药》2010年第11期1478-1480,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 探讨胰岛素强化治疗对非糖尿病患者体外循环术后外周血白细胞介素-10（IL-10）浓度及外周血单核细胞核因子-κKB（NF-κB）活性的影响.方法 80例患者随机分为两组,A组作为强化治疗组从手术开始即行胰岛素强化治疗,将血糖严格控制于4.4-8.3 mmoL/L.B组作为对照组将血糖控制在11.1 mmoL/L以下.在体外循环术前、术后分4个时点检测血液IL-10浓度及外周血单核细胞NF-κB活性.结果 两组病例的一般情况无明显差异.体外循环术后A组IL-10浓度较B组高,而外周血单核细胞NF-κB活性A组较B组低,差异有统计学意义.结论体外循环术中、术后应用胰岛素强化治疗、严格控制血糖可调控抗炎和促炎介质,减轻炎性反应.Objective To observe the effects of intensive insulin therapy on IL-10 level and NF-ΚB activity in peripheral blood mononuclear cells in patients undergoing cardiopulmonary bypass.Methods The non-diabetic patients undergoing cardiopulmonary bypass in our department were selected and assigned to intensive therapy group （group A,n=40） and received strict glycemic control after the initiation of surgery.And those who undergoing cardiac surgery but without strict glycemic control were assigned to routine therapy group （group B,n=40） as controls.The blood glucose in group A was maintained at 4.4～8.3mmol/L,whereas the glucose in group B was below 11.lmmol/L.The concentration of serum IL-10 and NF-ΚB activity in peripheral blood mononuclear cells was measured at different time points.Results There were no significant differences in general data between two groups.The concentration of IL-10 in group B was significantly lower than that in group A（P〈0.05）.compared with group B,strict glycemic control markedly suppressed NF-KB activation （P〈0.05）.Conclusion Intensive insulin therapy could reduce the activity of NF-ΚB and then reduce the expression of IL-10.Strict glycemic control could significantly mitigate the systemic inflammatory response.

关 键 词：体外循环 血糖 胰岛素 白介素-10 核因子-ΚB 

分 类 号：R65[医药卫生—外科学]