【摘要】 目的:观察胰岛素强化治疗在慢性阻塞性肺疾病(COPD)急性加重期伴应激性高血糖行有创机械通气中的治疗作用。方法:50例COPD急性发作期呼吸衰竭伴应激性高血糖进行有创机械通气患者随机分为常规治疗组(常规组)及胰岛素强化治疗组(强化组),观察两组肝肾功能异常及死亡例数、有创机械通气时间;并用酶联免疫吸附试验法(ELISA)检测两组治疗前、1、3、7天血清白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)含量,同时测定血清C反应蛋白(CRP)值。结果:强化组肝肾功能异常例数及有创机械通气时间显著少于常规组(P<0.05),两组死亡例数差异无显著性(P>0.05)。强化组治疗3天后血清IL-8、TNF-a及CRP含量较常规组显著降低(P<0.05或0.01)。结论:胰岛素强化治疗在COPD急性加重期伴应激性高血糖有创机械通气中有较好应用价值。更多还原

【Abstract】 Objective:To explore the effect of insulin intensive therapy in acute exacerbation of chronic obstructive pulmonary disease(AECOPD) with mechanic ventilation while complicated with stress hyperglycemia.Methods:50 patients with AECOPD complicated with stress hyperglycemia needing mechanic ventilation were randomly divided into intensive insulin therapy group and control group.Cases with abnormal hepatic function and abnormal renal function,cases of death,and time of mechanic ventilation were observed.Enzyme-linked immunoabsorbent assay(ELISA) method was used to determine serum tumor necrosis factor-α(TNF-α) and interleukin-8(IL-8) at pretreatment,1st,3rd,and 7th day.C reaction protein(CRP)serum level was also determined at same time.Results:Cases with abnormal hepatic function and abnormal renal function in intensive insulin therapy group were significantly decreased compared with those in control group(P<0.05),but there was no difference in death rate(P>0.05).After 3day,the serum levels of TNF-α,IL-8,and CRP were all significantly decreased compared with those in control group(P<0.05 or 0.01).Conclusion:Insulin intensive therapy is valuable in AECOPD with mechanic ventilation while complicated with stress hyperglycemia.更多还原