早期胰岛素强化治疗儿童脓毒症的疗效及对氧化应激的影响  

Curative effect of early intensive insulin treatment on children with pyemia and its influence on oxidative stress

作　　者：吕卓超[1] 潜丽俊[1] LV Zhuochao;QIAN Lijun(Department of Pediatrics,Lishui Central Hospital in Zhejiang Province,Lishui 323000,China)

机构地区：[1]浙江省丽水市中心医院儿科,浙江丽水323000

出　　处：《中国现代医生》2019年第2期8-11,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2016KYB337)

摘　　要：目的探讨早期胰岛素强化治疗儿童脓毒症的疗效及对氧化应激的影响。方法选取2014年10月～2018年6月在我院儿科住院治疗的儿童脓毒症患者64例,分为观察组和对照组。两组患儿予以抗感染、补充体液容量复苏、营养补充和原发病处理等基础治疗。观察组和对照组患儿在此基础上分别将胰岛素通过微泵持续泵入或常规胰岛素治疗,分别维持血糖(4.4～6.1)mmol/L和(10.0～11.1)mmol/L。分析治疗前和治疗7 d后血清过氧化氢酶(CAT)、活性氧(ROS)、谷胱甘肽过氧化物酶(GSH-Px)和晚期蛋白氧化产物(AOPPs)水平,并比较疗效。结果治疗前两组血清CAT、ROS、GSH-Px和AOPPs水平比较相接近(P>0.05)。治疗7 d后,两组血清ROS水平和AOPPs明显下降,血清CAT和GSH-Px水平明显上升,且观察组变化幅度更明显(P<0.05);观察组临床总有效率(93.75%)比对照组(75.00%)更佳(χ2=4.27,P<0.05)。结论早期胰岛素强化治疗儿童脓毒症患者的效果肯定,能降低血清ROS和AOPPs水平,升高血清CAT和GSH-Px水平,从而减轻氧化应激反应导致的氧自由基损伤。Objective To discuss the curative effect of early intensive insulin treatment on children with pyemia?and its influence on oxidative stress.Methods 64 cases of children with pyemia in Department of pediatrics in the hospital from October 2014 to June 2018were divided into observation group and control group.The children in two groups were given the basic treatment like broad-spectrum for anti-infection,supplement for fluid resuscitation,nutrition support and treatment for primary disease.The children in observation group were given continuous insulin infusion by micropump to maintain the blood sugar with 4.4-6.1 mmol/L,while the children in control group were given routine insulin to adjust the speed to maintain the blood sugar with 10.0-11.1 mmol/L.The serum catalase(CAT),reactive oxygen species(ROS),glutathione peroxidase(GSH-Px)and advanced oxidation proteinproducts(AOPPs)levels of children in two groups were observed and compared before and 7 days after treatment,and the clinical curative effect was compared as well.Results The serum CAT,ROS,GSH-Px and AOPPs levels of children in two groups were similar after comparison before the treatment(P >0.05).After 7 days'medical treatment,the serum ROS and AOPPs of children in two groups were obviously declined than before,while the serum CAT and GSH-Px levels were obviously rose than before,and the changing rates of children in observation group were much higher than those in control group(P<0.05).The total clinical efficiency of children in observation group(93.75%)were much favorable than those in control group(75.00%)(χ2=4.27,P<0.05).Conclusion The early intensive insulin treatment has reliable curative effect on children with pyemia,which can reduce the serum ROS and AOPPs levels and raise serum CAT and GSH-Px levels to reduce the damages of free radical due to oxidative stress reaction and fulfill treatment effect.

关 键 词：脓毒症 儿童 胰岛素强化治疗 氧化应激 

分 类 号：R459.7[医药卫生—急诊医学]