摘要
目的:探讨危重患者应激状态下有关应激激素的变化规律,以指导抢救、提高患者存活率。方法:检测10个病种、294例危重患者生长激素(GH)、胰高血糖素(GL)、胰岛素(INS)、皮质醇(PTF)、泌乳素(PRL)和血糖(BS),并与40例正常人作比较。结果:①不同性别、年龄的危重患者5种应激激素和BS的水平均无显著性差异(P均>0.05);②应激状态下294例患者GL〔(162.66±50.23)ng/L〕、PTF〔(305.56±46.16)μg/L〕、INS〔(20.55±5.60)mU/L〕和BS〔(7.76±2.35)mmol/L〕与正常对照组〔GL(99.96±42.32)ng/L,PTF(138.85±60.15)μg/L,INS(14.00±8.75)mU/L,BS(5.50±1.22)mmol/L〕比较,均有非常显著性差异(P均<0.01)。而GH和PRL在各组均无显著性差异(P均>0.05)。③患者GL、PTF、INS和BS升高越明显,病情越重,预后越差,但与病种无关。结论:①应激的早期需大剂量使用糖皮质激素;②应激状态下不宜静脉使用高渗葡萄糖液,补充平衡盐溶液有利于患者恢复;③动态监测应激状?
Objective:To investigate the clinical significance of changes in relevant stress hormones in stress states for guidance of emergency treatment and improvement of survival rate.Methods:Growth hormone (GH),glucagon (GL),insulin (INS),plasma total cortisol (PTF),prolactin (PRL),and blood sugar (BS) were determined in 294 stress patients suffering 10 different diseases;40 healthy volunteers served as controls.Results:①There were no significant differences in 5 stress hormones and blood sugar in male and female patients as well as different age patients.②Under stress states,GL,PTF,INS,and BS levels in patients were significant higher than those in controls respectively,GL:(162 66±50 23)ng/L vs.(99 96±42 32)ng/L;PTF:(305 56±46 16)μg/Lvs.(138 85±60 15)μg/L;INS:(20 55±5 60)mU/L vs.(14 00±8 75)mU/L;BS:(7 76±2 35)mmol/L vs.(5 50±1 22)mmol/L,all P <0 01 .However,no marked differences in GH and PRL levels were observed between 2 groups (both P >0 05).③Moreover,the more obvious increases of GL,PTF,INS and BS values,the worse the patients′ illness was, as well as poor outcome would be,regardless of the type of disease.Conclusions: ①A large dose of glucocorticoid should be administered at the initial stage of emergency.②Using high osmotic glucose solution is not recommended under stress conditions,and infusion with balance salt solution appears to be beneficial for recovery.Dynamic determination of BS would be useful for judging patients′ illness and making prognosis.
出处
《中国危重病急救医学》
CAS
CSCD
1998年第8期497-500,共4页
Chinese Critical Care Medicine
关键词
应激状态
激素
血糖
生长激素
胰高血糖素
stress state\ \ hormones\ \ blood sugar\ \ growth hormone\ \ glucagon\ \ insulin\ \ plasma total cortisol\ \ prolactin