【摘要】 目的探讨创伤患者急性期C肽(CP)、细胞间黏附分子-1(ICAM-1)、胰岛素抵抗(IR)的变化特点及其临床意义。方法创伤住院患者55例,分别于伤后24小时内、3、7天取静脉血,采用放射免疫法测定血清C肽(CP)及空腹胰岛素(FINS),酶联免疫吸附法测定ICAM-1、终点法测定果糖胺(FMN),GOD-PAP法测定空腹血糖(FPG)等数值,按1?(FPG×FINS)计算出胰岛素敏感性指数(IAI),观察不同时间段各值的变化特点并与正常对照组进行比较。结果(1)创伤患者在伤后24小时内CP、ICAM-1即显著升高,IAI显著降低,与正常对照组相比,差异显著(P<0.01~0.001);(2)伤后3天与正常对照组相比,CP仍增高,IAI降低,差异显著(P<0.01~0.001);(3)伤后7天,除CP外,其余指标趋于正常;(4)创伤后FMN与对照组相比无差异(P>0.05)。结论创伤急性期患者存在应激引起的糖代谢紊乱及炎性损伤,监测CP、ICAM-1、IR等指标对指导临床治疗、判断预后有一定的意义。更多还原

【Abstract】 Objective To investigate the change and clinical value of C-peptide(CP),intercellular adhesion molecular-1(ICAM-1),insulin resistance of traumatic patients.Methods Venous blood of 55 traumatic cases admitted in our hospital were taken and tested on 24 hours,3 days and 7 days after being injured: CP and fasting serum insulin(FINS),ICAM-1,fructosamine(FMN),fasting serum glucose(FBG)were tested by radioimmunoassay,ELISA,end-point method and GOD-PAP method respectively.Insulin acuity index(IAI) was figured out according to ’IAI=1∕(FPG×FINS)’ and the change of the data obtained on different time periods was observed and compared with the those of the control group.Results(1)In 24 hours,CP、ICAM-1 of the traumatic patients rose markedly,IAI reduced notably as compared with control group(P<0.01-0.001).(2)After 3 days,CP kept rising and IAI still reduced.There was significant difference between the CP and IAI of the patients and control group(P<0.01-0.001).(3)After 7 days,all the indexes except CP tented to return to normal value.(4)There was no significant difference between the FMN of the patients after injury and control group(P>0.05).Conclusion The patients in traumatic acute stage show disturbance of carbohydrate metabolism which is caused by stress and inflammatory damage.更多还原