GIK液对体外循环内分泌、代谢紊乱及胰岛素抵抗的防治作用

Effect of GIK solution on hormones,carbohydrate metabolism andinsulin resistance during cardiopulmonary bypass

本研究旨在探讨ＧＩＫ液对ＣＰＢ期ＩＲ、内分泌和代谢紊乱的防治作用。２０例瓣膜置换术病人分为ＧＩＫ组（ｎ＝１０）和对照组（ｎ＝１０）。分别在麻醉前、ＣＰＢ前、ＣＰＢ１５ｍｉｎ、开放主动脉５ｍｉｎ和停ＣＰＢ２０ｍｉｎ时采血测定血糖、胰岛素、Ｃ肽、生长激素、皮质醇和Ｈｃｔ。结果显示ＣＰＢ期ＧＺＫ组血糖、皮质醇浓度显著低于对照组（Ｐ＜０．０５），而胰岛素、Ｃ肽浓度显著高于对照组（Ｐ＜０．０１）。ＧＩＫ组生长激素浓度较对照组也有降低。结论：ＧＩＫ组对体外循环期导致的内分泌和代谢变化有较好的防治作用，增加胰岛素敏感性，并使胰岛β细胞分泌功能得到改善。

o determine the improving effect of GIK Solution on insulin resistance and metabolic disorder in patients receiving valve replacement operations without diabetes during the period of CPB , 20 patients were divided into 2 groups. GIK group(n=10) and control group(n=10). insulin , which was contained in GIK(I/G = 1:1)solution was infused continuously at a rate of 1u/kg/h into the patients of GIK group and nothing was done to the patients of control group during the period from induction of anesthesia to clamping aortic flow. 20 blood samples were obtained respectively from patients of two groups at the following intervals:(1) Before anesthesia (2) Before CPB (3)After 15 min CPB (4) 6 min after declamping of aorta (5) 20 min after CPB.Insulin, c - peptide, cortisol, growth hormone as well as blood glucose in samples were measured. The levels of blood glucose. cortisol are significantly reduced and c - peptide, while insulin sensitivity are increased in GIK group. Hormonal. carbohydrate metabolism responses and the secretion of pancreatic beta cells are improved by GIK Solution