腹腔感染病人不同感染阶段糖代谢及部分相关因素的变化

Alterations of glucose mertabolism and its related factors in patients with intra-abdominal infection

目的 :观察腹腔感染病人不同感染阶段糖代谢及部分相关因素的变化。 方法 :随机选择腹腔感染病人 ,感染 3～ 5天设为S1组 ,感染持续 1个月以上设为S2 组 ,健康志愿者为对照组 (C组 )。对上述各组分别行静脉法葡萄糖耐量试验 ,并测定胰岛素。 0时相加测高血糖素 (glucagon ,Gln)、皮质醇 (Cs)及肿瘤坏死因子 (TNF)。 结果 :S1组各时相血糖均显著高于对照组 (P <0 .0 1)。S2 组 30及 6 0min时血糖亦显著高于对照组 (P <0 .0 5 ) ,而 0、5及 12 0min与对照组无显著差异 ;与S1组相比较 ,S2 组 0及 12 0min时血糖显著下降 (P <0 .0 5 )。S1组和S2 组胰岛素显著高于对照组 (P <0 .0 5 ) ,S1和S2 两组之间无显著差异。S1组Gln和TNF显著高于对照组 (P <0 .0 5 )。 结论 :空腹血糖在早期感染阶段升高 ,而感染持续 1个月后正常 ,可能与早期感染阶段Gln和TNF的升高有关。腹腔感染病人不论哪个阶段 。

Objectives:To observe the changes of glucose metabolism and some relationed factors in abdominal infection patients during different phases. Methods:The patients of abdominal infection were selected randomly.10 patients with abdominal infection for 3～5 d were selected as S 1 group,7 patients of abdomind infection continaning for 1 month were selected as S 2 group and 10 health volunteers were enrolled to control group(C group).The intravenous glucose tolerance test and insuline release test,glucagon?Cs and TNF were measured. Results:Glucose concentration in S 1 group were significantly higher than in control group( P <0.01).The glucose concentration in S 2 group were significantly higher than in control group at 30 and 60 min( P < 0.05 ).When compared with S 2 group,glucose concentration of S 1 group were significantly declined at 0 and 120 min( P < 0.05 ).Insulin concentrations of S 1 group and S 2 group were significantly higher than in control group at 0,30,60 and 120 min( P <0.05).Insulin concentration of S 1 group was higher than in S 2 group at 5 min( P <0.05).Glucagon and Tumour necrotic facter concentration of S 1 group was significantly higher than in control group( P <0.05). Conclusions:The level of fasting blood glucose is elevated during early phase of sepsis and declined after 1 month.The glucose tolerance is declined with insulin resistance during all the course of sepsis.