早期强化胰岛素治疗对重症脓毒症患者血清IL-6及预后的影响

Effect of intensive insulin therapy at the early stage on the prognosis and serum IL-6 levels in patients with severe sepsis

目的探讨早期强化胰岛素治疗对重症脓毒症患者预后及血清IL-6的影响。方法选择重症脓毒症患者50例,随机分为强化胰岛素治疗组(强化组)和常规胰岛素治疗组(常规组),每组25例,酶联免疫吸附法(ELISA)检测血清IL-6的浓度。同时记录机械通气时间、住ICU时间和病死率。结果强化组机械通气时间、住ICU时间、ApachⅡ评分及病死率均明显降低(P<0.05或<0.01),血清IL-6浓度较常规组明显降低(P<0.05)。结论早期强化胰岛素治疗可以降低病死率,改善预后,可能与其抑制机体的炎性反应有关。

Objective To investigate the effect of intensive insulin therapy at the early stage on the prognosis and serum IL-6 levels in patients with severe sepsis, and to explore the potential mechanism of the intensive insulin therapy. Methods Fifty patients with severe sepsis were randomly divided into intensive insulin therapy group （ n = 25 ） and control group （ n = 25 ）. The enzyme-linked immunoadsorbent assay （ELISA） was used to determine the serum levels of interleukin-6 （IL-6）. The days of using mechanical ventilation and in ICU, mortality were measured. Results The days of using mechanical ventilation and in ICU, Apach Ⅱ scores and mortality in intensive insulin therapy group were decreased significantly, as compared with those in control group （ P 〈 0.05 ）. The serum levels of IL-6 in patients receiving intensive insulin therapy were significantly lower than those of patients without the therapy（ P 〈 0.05 or P 〈 0.01 ）. Conclusion Intensive insulin therapy at the early stage can decrease mortality, improve prognosis of patients with severe sepsis, which may be related to the inhibition of inflammatory reaction.