急性颅脑损伤后胰岛素抵抗、血清IL-6的相关性研究

Relationship of insulin resistance and IL-6 after acute brain injury

目的探讨不同程度、不同时间段急性颅脑损伤患者血糖、胰岛素水平关系及血清白细胞介素-6(IL-6)的含量变化及临床意义。方法 106例急性颅脑损伤患者按入院时GCS评分分为轻度、中度和重度3组,分别于伤后1、2、3、4、5d测定空腹血糖、血清胰岛素值并计算胰岛素抵抗指数(HOMA-IR),分析急性颅脑损伤程度与HOMA-IR之间关系;采用酶联免疫吸附(ELISA)法测定血清IL-6含量,根据IL-6的动态变化,分析急性颅脑损伤程度与血清IL-6含量之间关系。结果不同程度的急性颅脑损伤患者血糖、胰岛素水平及HOMA-IR比较差异有统计学意义(P<0.05),血糖、血清胰岛素和HOMA-IR越高,急性颅脑损伤的程度越重,同时血清IL-6含量在伤后高于对照组(P<0.05),而在重型颅脑损伤中增高较轻型和中型颅脑损伤更为明显(P<0.05)。结论空腹血糖值、HOMA-IR及血清IL-6含量与急性颅脑损伤程度存在相关性,可作为评估急性颅脑损伤严重程度及预后的一个客观指标。

Objective Analysis of acute brain injury in different degree and different period of time of blood glucose,insulin levels and the relationship between the serum levels of interleukin 6（IL-6） content change and its clinical significance.Methods 106 cases of acute brain injury patients according to their GCS scores were divided into mild,moderate and severe group three,respectively,after injury in 1D,2D,3D,4D,5D determination of fasting blood glucose,serum insulin values and calculated the insulin resistance index（HOMA-IR）,analysis of acute craniocerebral injury degree and the relationship between HOMA-IR;using enzyme ELISA（ELISA） method for the determination of the content of serum IL-6,according to the dynamic changes of IL-6,analysis of acute head injury severity and the content of serum IL-6 relationship.Results Different degree of acute craniocerebral injury patients blood glucose,insulin levels and HOMA-IR showed significant difference（P＆lt;0.05）,blood glucose,serum insulin and HOMA-IR higher,acute brain injury degree,while the content of serum IL-6 after injury in higher than that of control group（P＆lt;0.05）,while in severe traumatic brain injury in hypertension was light and medium damage was more evident（P＆lt;0.05）.Conclusion The fasting blood glucose,HOMA-IR and IL-6 in serum of acute brain injury degree and correlation,can be used as an assessment of acute head injury severity and prognosis in a objective index.