危重症患儿应激性高血糖和血清胰岛素组分变化的关系分析

被引：9

作者：

殷博

陆国平

陆铸今

张灵恩

机构：

[1] 上海,复旦大学附属儿科医院重症医学科

来源：

中华实用儿科临床杂志 | 2014年 / 29卷 / 06期

关键词：

危重症; 免疫反应性胰岛素; 真胰岛素; 应激性高血糖;

D O I：

暂无

中图分类号：

R720.597 [儿科急症及处理];

学科分类号：

100202 [儿科学];

摘要：

目的观察应激状态时, 危重症患儿血糖水平变化与疾病危重程度、免疫反应性胰岛素(IRI)水平、血清真胰岛素(TI)水平变化的关系。方法在PICU病房及呼吸科普通病房选取58例患儿入组, 分别为PICU组(42例)及普通组(16例)。PICU组患儿根据血糖检测结果分为高血糖组(20例)及非高血糖组(22例), 并进行小儿危重评分。所有入选患儿检测血清IRI、TI、C肽及血糖。结果高血糖组患儿入院时危重评分[(74.80±8.07)分]明显低于非高血糖组[(84.36±9.46)分], 差异有统计学意义(t=1.964, P<0.05)。且高血糖组病死率(45.0%, 9/20例)明显高于非高血糖组(13.6%, 3/22例), 差异有统计学意义(χ2=5.05, P<0.05)。入院时高血糖组患儿血清IRI、TI、C肽均显著高于非高血糖组及普通组, 差异有统计学意义(F=136.90、61.25、45.89, P均<0.05)。入院时高血糖组患儿TI/IRI显著低于非高血糖组及普通组, 差异有统计学意义(F=27.64, P<0.05)。高血糖组患儿入院48 h TI、C肽及TI/IRI值较入院时显著降低, 差异有统计学意义(t=2.241、2.087、2.014, P均<0.05)。结论危重症患儿存在应激性高血糖及血清胰岛素组分的变化, 血清TI绝对水平和比例下降。

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