颅脑外伤患者胰岛素抵抗程度与脑损伤、应激反应的相关性研究

Correlation of insulin resistance with cerebral injury and stress reaction in patients with craniocerebral trauma

目的:研究颅脑外伤患者胰岛素抵抗程度与脑损伤、应激反应的相关性。方法:选择在我院诊断为急性颅脑损伤的78例患者作为的TBI组,同期体检的90例健康志愿者作为对照组。采集外周血后检测葡萄糖、胰岛素、神经损伤标志分子、应激激素及氧化应激反应产物,计算胰岛素抵抗指数(HOMA-IR)。结果:TBI组的HOMA-IR指数显著高于对照组;TBI组血清中NSE、UCH-L1、S100β、MBP、胰高血糖素、生长激素、皮质醇、MDA、8-OHdG的含量显著高于对照组;高HOMA-IR患者的血清NSE、UCH-L1、S100β、MBP、胰高血糖素、生长激素、皮质醇、MDA、8-OHdG的含量显著高于低HOMA-IR患者。结论:颅脑外伤患者的胰岛素抵抗程度显著加剧且与脑损伤程度、应激反应程度密切相关。

Objective：To study the correlation of insulin resistance with the cerebral injury and stress reaction in patients with traumatic brain injury.Methods：A total of 78 patients who were diagnosed with acute craniocerebral injury in our hospital between May 2014 and August 2016 were selected as the TBI group,and 90 healthy volunteers who received physical examination during the same period were selected as the control group.The peripheral blood was collected to detect glucose,insulin and nerve injury marker molecules,stress hormones as well as oxidative stress reaction products,and the insulin resistance index（HOMA-IR）was calculated.Results：The HOMA-IR index of TBI group was significantly higher than that of control group;serum NSE,UCH-L1,S100β,MBP,glucagon,growth hormone,cortisol,MDA and 8-OHdG levels of TBI group were significantly higher than those of control group;serum NSE,UCH-L1,S100β,MBP,glucagon,growth hormone,cortisol,MDA and 8-OHdG levels of patients with high HOMA-IR were significantly higher than those of patients with low HOMA-IR.Conclusions：The insulin resistance increases significantly in patients with traumatic brain injury,and is closely related to the degree of cerebral injury and stress reaction.