【摘要】 目的探讨胰岛素强化治疗对严重创伤患者血清蛋白的影响。方法80例严重创伤患者按随机配对原则分为胰岛素强化治疗组(40例)和对照组(40例)。强化治疗组进行胰岛素强化治疗,对照组进行临床常规治疗,在强化或常规治疗前,治疗开始后1、3、7、10、14、21 d检测血清白蛋白(AL)、前白蛋白(PA)、视黄醇结合蛋白(RBP)和糖化血清蛋白(FMN)含量。结果2组患者伤后AL、PA、RBP水平均出现显著下降然后逐渐恢复过程,但AL伤后10 d强化组明显高于对照组(P<0.05),PA伤后7 d强化组明显高于对照组(P<0.05),RBP伤后3 d强化组明显高于对照组(P<0.05)。FMN伤后早期无明显变化,14 d后有所升高,但强化组明显低于对照组。结论胰岛素强化治疗通过降低严重创伤患者的应激性高血糖,有助于血清蛋白的恢复和营养状态的改善。更多还原

【Abstract】 Objective To investigate the effects of intensive insulin therapy on the serum proteins in severe trauma patients.Methods Eighty severe trauma patients were randomly divided into the intensive insulin therapy group(n=40) and routine therapy group(n=40).The insulin pump was given to the first group to keep the blood glucose in the range of 6 to 8 mmol/L and routine treatment was carried out at the same time.The patients of the routine therapy group had similar calorie intake as insulin group did.The values of albumin(AL),prealbumin(PA),retinol-binding protein(RBP) and fructosamine(FMN) in serum were assayed before intensive insulin therapy and at day 1,3,7,10,14 and 21 after therapy.Results The levels of serum proteins were obviously decreased at early stage and restored at later stage after severe trauma.But the levels of AL at day 10,PA at day 7,RBP at day 3 after therapy in the intensive insulin therapy group were significantly improved as compared with routine therapy group.The levels of FMN at day 14 after therapy in the intensive insulin therapy group were significantly lower than those in routine therapy group(P<0.05).Conclusion Intensive insulin therapy strictly controls the blood sugar of severe trauma patients,which can effectively restore serum proteins and improve the status of nutrition.更多还原