先天性心脏病患者体外循环结束后早期糖耐量的观察和外源性胰岛素对它的影响

Early glucose utilization ratio and influence of exogenous insulin on the glucose tolerance in patient with congenital heart disease after cardiopulmonary bypass

静脉法葡萄糖耐量试验观察先天性心脏病(先心)患者体外循环(CPB)结束后早期的糖利用情况和外源性胰岛素对糖耐量的影响.结果示:CPB结束后早期左向右分流先心患者糖耐量与术前比明显下降(P<0.01),但4例法乐氏四联症患者糖耐量无明显下降.另外两组在向右分流先心患者按葡萄糖比胰岛素4g:lu和2g:lu混合给予静脉推注,CPB后糖耐量与术前比较无显著差异,糖利用系数变化率分别为99.3%和133%.结果表明:左向右分流先心患者CPB结束后早期糖利用障碍,应用胰岛素可明显改善糖利用率,4g:lu给予糖和胰岛素糖利用系数与术前最接近.

The venous glucose tolerance tests (GTT ) , early glucose utilization ratio and the influence of exogenous insulin on GTT were studied in patients with congenital heart disease (CHD)aftcr cardiopulmonary bypass ( CPB ).Compared with pre-operation, the early GTT after CPB fell markedly in patients with shunting from left to right and did not significantly change in patients with tetralogy of Fallot. Compared the second group with tetralogy of Follot.Compared the second group with the third group, the GTT after CPB were not significantly different from preoperation.The results suggested that the early glucose utilization disturbance might occur in patients with shunting from left to right after CPB and that early glucose utilization could be obviously improved by administrating insulin.When exogenous insulin was administrated, the glucose utilization coefficient after CPB is similar to pre-operation.