不同血糖控制水平对PICU脓毒症患儿炎性反应状态和治疗效果的影响  

Effects of Different Blood Glucose Control Levels on Inflammatory Response Status and Therapeutic Effect in Children with PICU Sepsis

作　　者：何智富 伍少霞 马可泽 卢少晶 陈素君 HE Zhifu;WU Shaoxia;MA Keze;LU Shaojing;CHEN Sujun(Department of PICU,The Eighth People's Hospital of Dongguan(Dongguan Children's Hospital),Dongguan Guangdong,523321,China)

机构地区：[1]东莞市第八人民医院(东莞市儿童医院)PICU,广东东莞523321

出　　处：《临床研究》2022年第8期46-48,共3页Clinical Research

摘　　要：目的分析在儿科重症监护病房(PICU)脓毒症患儿治疗过程中不同血糖控制水平对于患儿炎性反应状态与临床治疗效果的影响。方法选取2019年1月至2019年12月期间东莞市第八人民医院收治的PICU脓毒症患儿50例作为本次研究的对象,采用随机列表法将患儿分为两组进行治疗干预,对照组患儿血糖指标控制在6.1~8.5 mmol/L,研究组患儿血糖指标控制在4.5~6.0 mmol/L。治疗两周后,对两组患儿在临床过程中的炎性反应指标与治疗效果进行对比分析。结果在进入PICU前,两组患儿TNF-α、Wnt5a及IL-4等炎性反应水平指标比较,差异无统计学意义(P>0.05);在进入PICU 1 d、进入PICU 3 d、进入PICU 7 d后,两组患儿TNF-α与Wnt5a水平均出现降低趋势,且研究组下降幅度大于对照组,差异均具统计学意义(P<0.05);经过治疗后,两组患儿IL-4指标均出现明显波动,在进入PICU 1 d、进入PICU 3 d时,该指标明显上升,经过治疗后,随着患儿炎症情况的缓解,在进入PICU 7 d时,该指标出现下降趋势,在其过程中,研究组在进入PICU 1 d时,该指标高于对照组,在进入PICU 3 d、7 d时,该指标低于对照组,差异均具统计学意义(P<0.05);研究组PICU治疗用时短于对照组,差异具有统计学意义(P<0.05);研究组多器官功能障碍综合征(MODS)发生率与死亡率低于对照组,但组间比较差异无统计学意义(P>0.05)。结论在PICU脓毒症患儿治疗过程中,将其血糖水平控制在4.5~6.0 mmol/L,有利于抑制TNF-α与Wnt5a的释放,同时促进IL-4的产生与分泌,有利于患儿炎症反应的合理控制,缩短患儿临床治疗时间,具有积极价值,值得应用。Objective To analyze the effects of different blood glucose control levels on the inflammatory response status and clinical treatment effect of pediatric intensive care Unit(PICU)for children with sepsis.Methods Fifty children with PICU sepsis admitted to The Eighth People's Hospital of Dongguan(Dongguan Children's Hospital)from January 2019 to December 2019 were selected as the objects of this study.The children were divided into two groups for treatment intervention using random list method.The blood glucose index of the control group was controlled between 6.1 and 8.5 mmol/L.The blood glucose index of the children in the study group was controlled between 4.5 and 6.0 mmol/L.After two weeks of treatment,the inflammatory response indexes and treatment effects of the two groups were compared and analyzed.Results Before entering PICU,there was no statistical significance in TNF-α,Wnt5a,IL-4 and other inflammatory response indexes between two groups(P>0.05).After entering PICU 1 d,3 d and 7 d,the levels of TNF-αand Wnt5a in both groups showed a decreasing trend,and the decrease rate in the study group was greater than that in the control group,the differences were statistically significant(P<0.05).After treatment,IL-4 indexes in both groups showed significant fluctuations,which increased significantly on day 1 and day 3 of PICU entry.After treatment,with the alleviation of inflammation,IL-4 indexes showed a downward trend on day 7 of PICU entry.During the process,the study group showed significant fluctuations in IL-4 indexes after day 1 of PICU entry.This index was higher than that of the control group,and lower than that of the control group at 3 and 7 days after entering PICU,with statistical significance(P<0.05).The duration of PICU treatment in the study group was shorter than that in the control group,and the difference was statistically significant(P<0.05).The incidence and mortality of Multiple Organ Dysfunction Syndrome(MODS)in the study group were lower than those in the control group,but there was no s

关 键 词：脓毒症 血糖控制 炎性反应 临床价值 

分 类 号：R720[医药卫生—儿科]