胰岛素强化治疗对高血糖严重烧伤患者血清脂联素和C反应蛋白的影响

Effects of intensive insulin therapy on serum adiponectin and C-reactive protein in severely burned patients compli-cated by hyperglycemia

目的探讨胰岛素强化治疗对高血糖严重烧伤患者血清脂联素和C反应蛋白的影响。方法 40例重度烧伤患者随机分为胰岛素强化治疗组(血糖控制在4.4～6.1mmol/L)和胰岛素常规治疗组(血糖控制在10.0～11.1mmol/L),分别于治疗前和治疗24h、3d、10d抽血测定脂联素和CRP水平。结果胰岛素强化治疗组血清脂联素较治疗前及常规治疗组明显升高(P<0.01),CRP较常规治疗组明显降低(P<0.01)。结论胰岛素强化治疗使血糖控制在4.4～6.1mmol/L,可拮抗烧伤后机体呈现的高炎状态,改善胰岛素抵抗。

Objective To investigate the effects of intensive insulin therapy on serum levels of adiponectin and C-reactive proteinin severely burned patients complicated by hyperglycemia.Methods Forty severely burned patients were randomly divided into intensive insulin therapy group （maintain blood glucose between 4.4～6.1mmol/L） and conventional therapy group（maintain blood glucose between 10.0～11.1mmol/L）.ELISA method was used to determine the adiponectin and CRP levels on 24h,3d and 10d after admission.Results Serum levels of CRP in patients received intensive insulin therapy were significantly lower than those who received conventional therapy （P〈0.01）,whereas adiponectin levels were significantly higher than conventional group（P〈0.01）.Conclusion Intensive insulin therapy to maintain blood glucose between 4.4～6.1mmol/L can alleviate the inflammation response to severe burn and improve insulin resistance.