心肺转流术对血糖、胰岛素水平的影响

Influence of cardiopulmonary bypass on blood glucose and insulin levels

目的：观察心内直视手术时的体外循环（ＣＰＢ）对血糖、胰岛素水平的影响。方法：２８例心脏病手术患者分别于麻醉前、ＣＰＢ前、ＣＰＢ１０ｍｉｎ、ＣＰＢ３０ｍｉｎ、心脏复跳后５ｍｉｎ、ＣＰＢ结束时抽取血标本测定血糖、胰岛素含量。结果：血糖和胰岛素浓度在ＣＰＢ期和ＣＰＢ结束时显著高于ＣＰＢ前（Ｐ＜０．０１），麻醉前与ＣＰＢ前比较无明显变化（Ｐ＞０．０５）。结论：ＣＰＢ期胰岛素水平增加，但组织对胰岛素的敏感性降低，对葡萄糖的利用率下降，机体发生胰岛素耐受。

Objective:To determine the influence of cardiopulmonary bypass(CPB) on blood glucose and insulin.Methods:Blood samples were obtained from 28 patients at differen time:before anesthesia,before CPB,10 min after lowing CPB,30 min after CPB,5 min after heart rebeat and CPB close.The plasma insulin and glucose levels were measured.Results:The blood glucose and insulin levels during and after CPB were significantly increased( P <0.01),but the change in blood glucose and insulin levels before anesthesia and before CPB was not significant( P >0.05).Conclusions:Insulin level increased during CPB,but insulin sensitivity of tissue decreased,utilization of glucose decreased.