术后重症患者β细胞功能改变初探

The change of β cell function in postoperative critically ill patients

目的探讨术后重症患者β细胞功能改变及其与预后的关系。方法32例术后入ICU患者年龄〉16岁且无糖尿病病史，根据APACHEII评分是否〉10分，分为对照组和重症组。测定术前当日及术后第1天清晨空腹胰岛素（FINS）、空腹C肽（FCP）并计算HOMA-β细胞功能指数。结果重症组术后第1天FINS、FCP、HOMA-β细胞功能指数与术前当日比较差异均有统计学意义（均P〈0．05），与对照组比较差异均有统计学意义（均P〈0.05）；术后第1天FINS、空腹C肽、HOMA-β细胞功能指数与APACHE Ⅱ评分、APACHE Ⅲ评分和住ICU天数高度负相关。结论术后重症患者可能存在胰岛β细胞功能不全。

Objective To evaluate the changes of β cell function in critically ill surgical patients and its relationship with prognosis. Methods 32 patients 〉 16 years age with no history of diabetes who were admitted to surgical intensive care unit （SICU） were divided into two groups according to APACHE Ⅱ score. Blood sample was taken on preoperative and postoprative 1st day for measures of fasting insulin （ FINS） and fasting C peptide （ FCP）. The HOMA-β was calculated. Results The level of FINS, FCP and HOMA-β were significantly decreased on first day after operation than preoperative in critical group. Compared with control group, The level of FINS, FCP and HO- MA - βwere significantly reduced on first day after operation, which had negative correlation with APACHE Ⅱ score, APACHE Ⅲ score and in charge days of ICU. Conclusion There is β cell dysfunction in critically ill surgical patients. β cell function in surgical critically ill patients is negatively correlated with APACHE Ⅱ score, APACHE Ⅲ score and days of ICU.