腹部择期手术患者胰岛素抵抗临床观察

被引：6

作者：

贾建国

陈宏

薛纪秀

张淑文

机构：

[1] 首都医科大学宣武医院普外科

[2] 首都医科大学宣武医院普外科北京100053

来源：

中国临床营养杂志 | 2008年 / 03期

关键词：

胰岛素抵抗; 手术; 稳态模式评估法;

D O I：

暂无

中图分类号：

R656 [腹部外科学]; R587.1 [糖尿病];

学科分类号：

1002 ; 100201 ; 100210 ;

摘要：

目的研究外科择期手术患者胰岛素抵抗(IR)的临床意义,探讨与IR的相关因素。方法选择腹部择期手术患者14例,分别检测患者术前1天、术中(手术开始后1小时)、术后24小时血浆肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、血糖、胰岛素水平,利用稳态模式评估法(HOMA)计算胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数和胰岛素敏感指数(ISI)。结果术后血糖、胰岛素、IL-6、TNF-α水平较术前、术中均显著升高(P<0.001),术中IL-6水平亦显著高于术前(P=0.017),而术前与术中的血糖、血胰岛素、TNF-α水平差异无显著性(分别P=0.421,P=0.116,P=0.076)。术后HOMA-IR显著高于术前(P<0.001)。ISI与手术时间(r=-0.936、P<0.001)、术中出血量(r=-0.594、P=0.032)、术后TNF-α水平(r=-0.641、P=0.018)呈显著负相关。结论腹部择期手术患者存在IR。缩短手术时间、降低手术创伤强度、减少出血对减轻IR具有重要意义。

引用

页码：152 / 155

页数：4

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