胰岛素强化治疗对脓毒症患者血清非特异性炎性因子表达水平及预后的影响

Effect of intensive insulin therapy on non-specific inflammatory factors and prognosis in patients with sepsis

目的探讨胰岛素强化治疗对脓毒症患者非特异性炎性因子表达水平及预后的影响。方法将2011年2月至2012年10月本院重症监护病房收治的50例脓毒症患者随机分为对照组和观察组,对照组患者给予常规胰岛素治疗,观察组患者给予胰岛素强化治疗,比较两组患者的预后情况及血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和C反应蛋白(CRP)等血清非特异性炎性因子水平的差异。结果观察组患者ICU入住时间短于对照组,病死率小于对照组(P<0.05),且两组患者治疗1、3、5、7d后的血清TNF-α、IL-6、CRP水平比较差异均有统计学意义(P<0.05)。结论胰岛素强化治疗可以有效降低脓毒症患者血清TNF-α、IL-6、CRP等炎性因子的水平,并显著改善患者的预后,值得临床推广应用。

Objective To explore the effect of intensive insulin therapy on non-specific inflammatory factors and prognosis in patients with sepsis.Methods During February 2011 and October 2012,a total of 50 patients with sepsis were enrolled and randomly divided into control group and observation group,with 25 patients for each group. Patients in control group were given conventional insulin therapy,and patients in observation were given intensive in-sulin therapy.Prognosis and serum levels of tumor necrosis factor-α（TNF-α）,interleukin-6 （IL-6 ）and C-reactive protein （CRP）were detected and compared between the two groups.Results The prognosis of observation group was better than control group,and serum levels of TNF-α,IL-6 and CRP,detected 1,3,5 and 7 days after therapy, with statistical difference between the two groups （P＆lt;0.05）.Conclusion Intensive insulin therapy could reduce se-rum levels of TNF-α,IL-6 and CRP in patients with sepsis,and significantly improve the prognosis of patients,which might be worthy of clinical application.