儿童危重症应激性高血糖对器官功能的影响  

Effects of stress hyperglycemia on organ function in critically ill children

作　　者：武洁[1] 王荃[1] WU Jie;WANG Quan(Department of Emergency,Beijing Children’s Hospital,Capital Medical University,National Children’s Medical Center,Beijing 100045,China)

机构地区：[1]首都医科大学附属北京儿童医院,北京100045

出　　处：《临床儿科杂志》2023年第6期406-410,共5页Journal of Clinical Pediatrics

摘　　要：重症患儿在应激状态下可出现应激性高血糖(SHG)。目前认为SHG的发病机制与危重症时的内分泌激素调节异常、细胞因子大量释放以及胰岛素抵抗相关。血糖水平持续增高可引起线粒体功能障碍、炎症途径激活和氧化应激。近年来,虽然SHG与不良预后之间的相关性受到广泛关注,但严格控制血糖联合强化胰岛素治疗的策略似乎并不能让重症儿童获益,总体而言,血糖不超过180 mg/dL(10.0 mmol/L)为宜。文章梳理SHG的定义、发病机制及对机体的危害等方面的研究进展,以期提高临床医师认识。Stress-induced hyperglycemia(SHG)may occur in severe children under stress.It is currently believed that the pathogenesis of SHG is related to abnormal regulation of endocrine hormones,massive release of cytokines,and insulin resistance in critical cases.Continuous elevated blood glucose levels can cause mitochondrial dysfunction,activation of inflammatory pathways,and oxidative stress.Although the association between SHG and poor prognosis has received widespread attention in recent years,strategies to strictly control blood glucose combined with intensive insulin therapy do not seem to benefit critically ill children.In general,blood glcose not exceeding 180 mg/dL(10.0 mmol/L)is appropriate.This article reviews the progress of research on the definition,pathogenesis and harm of SHG in order to improve clinicians’understanding.

关 键 词：应激性高血糖 危重病 儿童 

分 类 号：R720.597[医药卫生—急诊医学]