体外循环患者发生胰岛素抵抗的危险因素分析  

Analysis of Risk Factors of Insulin Resistance in Patients Undergoing Cardiopulmonary Bypass

作　　者：王洁 王秀娟[1] 叶晓枫[1] WANG Jie;WANG Xiujuan;YE Xiaofeng(Department of Cardiology,Fujian Medical University Affiliated Union Hospital,Fuzhou 350001,Fujian Province,China)

机构地区：[1]福建医科大学附属协和医院心外科,福建350001

出　　处：《中国实用乡村医生杂志》2023年第3期28-31,35,共5页Chinese Practical Journal of Rural Doctor

摘　　要：目的分析体外循环患者术后早期发生胰岛素抵抗的危险因素,为减少体外循环患者胰岛素抵抗发生风险提供相关依据。方法选取2020年10月—2022年12月在福建医科大学附属协和医院进行体外循环瓣膜置换术的80例患者为研究对象,根据患者术后早期是否发生胰岛素抵抗将其分为抵抗组43例和未抵抗组37例,对比两组患者的临床资料;采用多因素logistic回归分析体外循环患者发生胰岛素抵抗的危险因素。结果本次80例体外循环患者术后早期有43例发生胰岛素抵抗,胰岛素抵抗发生率为53.75%。抵抗组年龄、体质量指数(body mass index,BMI)、使用右美托咪定、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、白介素-6(interleukin,IL-6)与未抵抗组比较差异均有统计学意义(均P<0.05)。单因素及多因素logistic回归分析显示,高龄、高BMI、高水平TG、高水平IL-6是体外循环患者术后早期胰岛素抵抗发生的危险因素(P<0.05)。结论体外循环患者术后早期发生胰岛素抵抗的危险因素包括高龄、高BMI、高水平TG、高水平IL-6,临床上可监测相关指标,评估体外循环患者术后早期发生胰岛素抵抗情况,并针对性干预。Objective To analyze the risk factors of insulin resistance in patients with cardiopulmonary bypass(CPB)in the early stage after operation,and to provide relevant basis for reducing the risk of insulin resistance in patients with CPB.Methods A total of 80 patients who underwent cardiopulmonary bypass valve replacement in Fujian Medical University Affiliated Union Hospital from October 2020 to December 2022 were selected as the study subjects.The patients were divided into resistance group(n=43)and non-resistance group(n=37)according to whether they developed into insulin resistance in the early stage after operation.The clinical data of the two groups were compared and the risk factors of insulin resistance in patients undergoing cardiopulmonary bypass were analyzed by multivariate logistic analysis.Results Firty-three patients with CPB developed into insulin resistance at the early stage after operation,and the incidence rate of insulin resistance was 53.75%.There were significant differences in age,BMI,use of dexmedetomidine,TG,HDL-C,LDL-C,IL-6 between two groups(all P<0.05).Univariate logistic regression analysis and multivariate logistic regression analysis showed that advanced age,high BMI,high level of TG,and high level of IL-6 were risk factors for early insulin resistance in patients undergoing cardiopulmonary bypass(P<0.05).Conclusion The risk factors of early postoperative insulin resistance in patients with cardiopulmonary bypass include advanced age,high BMI,high level of TG,and high level of IL-6.Clinically,relevant indicators can be monitored to evaluate the occurrence of early postoperative insulin resistance in patients with cardiopulmonary bypass,so that to adopt targeted intervention.

关 键 词：体外循环 胰岛素抵抗 危险因素 体质量指数 高甘油三酯血症 白介素-6 

分 类 号：R58[医药卫生—内分泌]