危重患者应激状态下血糖及皮质醇的变化分析

Changes of blood sugar and cortisol in critically ill patients under stress condition

目的探讨危重患者应激状态下血糖及皮质醇的变化对病情发展以及预后的意义。方法将2008-02～2012-02收治的46例危重患者作为研究对象(主要为脏器功能衰竭者),其中单脏器功能衰竭的设为观察A组(23例),多脏器功能衰竭的设为观察B组(23例),比较两组患者血糖以及相关激素的分泌情况和胰岛素量的使用情况。结果观察B组患者的血糖、血清胰岛素、皮质醇、胰高血糖素显著高于观察A组(P均<0.01),胰岛素的用量亦大于观察A组(P<0.01)。结论危重患者在应激状态下血糖以及其相关激素的分泌会增加,对患者血糖和相关激素变化进行动态监测对判断患者的病情变化有一定的参考价值。

Objective To investigate the changes of blood sugar and cortisol in critically ill patients in stress state and their significance for the progression and prognosis of the disease.Methods From Feb.2008 to Feb.2012,46 critically ill patients were the research subjects.They were mainly cases with major organ failure.Cases of single organ failure were Group A.Cases of multiple organ failure were Group B.The blood sugar as well as related hormone secretion and the amount of insulin use of the two groups were compared.Results The blood sugar,blood insulin,cortisol and glucagon of Group B were higher than those of Group A（P ＆lt; 0.01）.Also,the amount of insulin in Group B is higher（P ＆lt; 0.01）.Conclusion For critically ill patients with stress state,their blood sugar as well as related hormone secretion will increase,which has the reference value to monitor the patients’changes of blood sugar and related hormone dynamically and to judge their changes in condition.