危重症血糖的初步探讨

Preliminary investigation of serum glucose in critically ill patients

目的探讨危重患者不同组的血糖、血清胰岛素和C肽的差别,分析各组内血糖与胰岛素、C肽的相关性。方法选择2010年5月至2011年12月入住深圳市福田区人民医院ICU病房的222例危重患者,测定24 h内的血糖、血清胰岛素、C肽及进行急性生理和慢性健康状况Ⅱ评分(acute physiology and chronic health evaluationⅡ,APACHEⅡ评分)。按病史分为糖尿病组及对照组,比较两组间的血糖、血清胰岛素、C肽水平,分析不同组别的血糖与血清胰岛素、C肽的相关性。结果对照组血糖[(8.2±3.5)mmol/L]高于糖尿病组[(7.7±2.1)mmol/L],但两组比较差异无统计学意义(P>0.05);糖尿病组血清胰岛素[(67±110)μIu/ml]高于对照组[(11±8)μIu/ml],差异无统计学意义(P>0.05);对照组C肽[(4.6±1.0)μg/L]高于糖尿病组[(1.8±1.8)μg/L)],差异有统计学意义(P<0.05)。两组血糖与血清胰岛素、C肽无直线相关。结论 ICU危重症糖尿病与非糖尿病患者出现同样血糖、血清胰岛素。反应胰岛细胞功能的C肽,非糖尿病患者高于糖尿病患者。危重症患者血糖与血清胰岛素、C肽无线性相关。

Objective To investigate the differences of blood glucose,serum insulin and C peptide between different critically ill patients groups and analyze the correlation of blood glucose with insulin and C peptide in different groups.Methods Two hundred and twenty-two patients admitted in ICU wards from May 2010 to December 2011 in futian hospital were choosed,the blood glucose,serum insulin,C peptide and APACHE Ⅱ scores were measured within 24 h after admission.According to the medical history,the patients were divided into two groups： diabetes group and control group.The levels of blood glucose,serum insulin and C peptide of the two groups were compared.Linear correlation was conducted to study the correlation of blood glucose,serum insulin and C peptide.Results The level of C peptide [（4.6±1.0）μg/L]was higher in control group than that[（1.8±1.8）μg/L] in the diabetes group,the level of blood glucose [（8.2±3.5）mmol/L]was higher in control group than that[（7.7±2.1）mmol/L] in the diabetes group,but there was no significant difference between the two groups（P〉0.05）.The serum insulin[（11±8）μIu/ml]was lower in control group than that[（67±10）μIu/ml] in diabetes group,but there was no significant difference（P〉0.05）.There was no linear correlation between blood glucose and serum insulin,C peptide.Conclusion The blood glucose and serum insulin changes between the two groups are the same.The C peptide is higher in non-diabetic critically ill patients than that in diabetic critically ill patients,which represents the function of pancreatic islet cells.There is no linear correlation between blood glucose and serum insulin,C peptide in the critically ill patients.