果糖注射液对胸外科术后患者血糖和胰岛素的影响及安全性的临床研究

Effects of fructose on serum glucose and insulin levels and its safety in post - thorax surgical patients

目的比较果糖注射液（商品名：丰海能）和葡萄糖注射液对胸外科术后患者血糖和胰岛素的影响及安全性。方法前瞻性单盲随机对照研究。选取胸外科临床有效病例60例，于手术当天至术后第6天静脉滴注10％果糖注射液（试验组）或10％葡萄糖注射液（对照组），750ml／d，3h内输注完，连用7d。观察患者用药前和用药中血糖和胰岛素水平的变化情况，比较两组之间的差别。同时观察用药前后血尿酸、尿素氮、肝肾功能、心电图等变化以及不良反应的发生情况。结果试验组输液前后血糖变化值为（0．64±1．98）mmol／L，对照组输液前后血糖变化值为（4．13±1．63）mmol／L，对应试验组比较差异有统计学意义（P〈0．05）。试验组用药中对血胰岛素影响亦较小（0．82±9．76）mmol／L，对照组该指标明显升高（8．35±8．55）mmol／L，组间比较差异有统计学意义（P〈0．05）。用药后两组患者均未发现血尿酸、尿素升高，肝肾功能和心电图等指标无明显异常变化，未出现不良反应。结论适量静脉输注果糖注射液对胸外科术后患者血糖和胰岛素的影响较小，有较好的安全性。

Objective To compare fructose injection with glucose injection in the effectiveness and safety in stabilization of serum glucose and insulin levels in post - thorax surgical patients. Methods A survey on 60 patients subject to thorax - surgery was carried out by a randomized single blind parallel controlled prospective study. The patients in study group were administered with 750 ml/day 10% fructose injection intravenously in 3 h in a series of 7 days since the right - day of operation, while 10% glucose injection was administered in control group. The changes of serum glucose and insulin levels before and during injection, uric acid, uric nitrogen, liver and renal functions, ECG and adverse events were observed. Result After the injection 750 ml of 10% fructose, the changes of serum glucose were only （0.64 ± 1.98 ） mmol/L and insulin （0.82 ± 9.76） mmol/L. However, the serum glucose and insulin in control group were increased remarkably,which were （4.13 ± 1.63 ） and （8.35± 8.55 ） mmol/L respectively. There was significant difference between two groups （ P 〈 0.05 ）. No adverse events were observed in both two groups. Conclusion Adequate intravenous injection of fructose is safe and has relatively mild effects on serum glucose and insulin levels.