危重症患者胰岛素分泌功能变化及与部分炎症因子相关性

Relationship between the change of insulin secretionin Critical Patients and Some inflammatory Factors

目的探讨危重症患者胰岛素分泌功能变化及其与白细胞介素-6(IL-6)、C反应蛋白(CRP)的相关性。方法选取2012年1月—2013年12月该院收治的危重症患者101例,按入院后血糖水平分危重非高血糖组(51例)及危重并高血糖组(50例),分别测定空腹血糖(FBG)、空腹胰岛素(Fins)、IL-6、CRP等,计算稳态模型胰岛β细胞功能指数(HOMA-β),并与52例健康人进行比较。结果健康人、危重非高血糖患者、危重并高血糖患者相比FBG、IL-6、CRP依次升高(F=124.402、184.523、695.431,P<0.01),Fins、HOMA-β依次下降(F=12.795、239.241,P<0.05或P<0.01),HOMA-β与IL-6、CRP呈负相关(r=-0.729,-0.773,P<0.01)。结论危重应激高血糖与胰岛β细胞功能下降有关,炎症反应是危重症患者胰岛β细胞功能下降的原因之一。

Objective To discuss relationship among the change of insulin secretion in critical patients and some inflammatory factors. Methods 101 critical patients were divided into the critical illness with high blood sugar group （51 cases） and the critical illness without high blood sugar group （50 cases）according to the blood glucose levels after entering the hospital, fasting blood- glucose （FBG）, fasting insulin （Fins）, IL-6 and high-sensitivity C-reactive protein were determined separately, thelslet beta cell function index （HOMA-B）was calculated, and compared with 52 cases healthy patients. Results The healthy people, the critical patients without high blood sugar and critical patients with high blood sugar compared with IL-6, hs-CRP, HOMA-B levels were rising successively （F=12.795,239.241,P〈0.01）,IL-6, hs-CRP and HOMA-B were negative correlation （r= -0.729,-0.773,P〈 0.01）. Conclusions There was a relationship among the critical illness with stress hyperglycemia and decline of islet B-cell function, inflammatory reaction one of the reasons of decline of islet B-cell function among critical patients.