严重创伤MODS患者胰岛素抵抗和胰岛素分泌指数变化  

Clinical Significance of changes of Index of Insulin Resistance and secretion Assessed by Homeostasis Modelh Assessment in MODS trauma hemorrhage patients

作　　者：王占科[1] 冯青青[1] 杨莉萍[1] 熊小平[1] 陈自立[1] 许霖水[2] 陈致怀[1] 

机构地区：[1]南昌解放军94医院,江西南昌330002 [2]第三军医大学生化教研室,重庆630000

出　　处：《中国现代医学杂志》2004年第1期85-87,共3页China Journal of Modern Medicine

摘　　要：目的　探讨胰岛素抵抗和胰岛素分泌功能变化在创伤失血多器官功能不全综合征 (MODS)中的临床意义。方法　观察创伤失血MODS患者稳态模式评估法胰岛素抵抗指数 (HOMA -IR) ,胰岛素分泌指数 (HOMA - β)、空腹血糖、空腹乳酸、空腹乳酸和丙酮酸比值等的变化 ,并对MODS主要器官功能指标 ,细胞氧化水平指标与HOMA -IR指数进行相关和回归分析。结果　创伤失血MODS组HOMA -IR指数、乳酸、乳酸和丙酮酸比值 ,胰高血糖素和皮质醇等含量均明显高于正常对照组 (P <0 .0 1) ,HOMA - β指数明显低于正常对照组。创伤失血MODS严重程度与HOMA -IR指数明显正相关 (P <0 .0 1)。结论　测定HOMA -IR指数和HOMA - β指数可作为MODS患者转归 ,预后的预警指标。Objective:To elucidate the roles of insulin resistance and secretion on the trauma hemorrhage patients with MODS. Methods:The Indexes of HOMA-IR, HOMA-β, FGLU, FLA, FPA,LA/PA have been determined, and The correlations and regression- equations between the HOMA-IR and the indexs related to MODS in trauma hemorrhage patients have been analyzed. Results:The levels of HOMA-IR, FGLU, FLA, FPA,LA/PA in MODS patients are significant higher than that of the controls. There is a significant correlations between the HOMA-IR and the indexs related to MODS in trauma hemorrhage patients.Conclusion: The estimation of index of HOMA-IR and HOMA- β would contribute to the diagnosis for the MODS of trauma hemorrhage patients.

关 键 词：创伤 失血 MODS 胰岛素抵抗 失代偿 

分 类 号：R587[医药卫生—内分泌]