胰岛素受体改变及血糖控制对危重症患者的影响

胰岛素受体改变及血糖控制对危重症患者的影响

王超;张彤彦;许媛;赵京阳;何伟;李彤;周华;赵栋

【期刊名称】《中华外科杂志》 【年(卷),期】2008(046)012

【摘要】Objective To investigate the changes of insulin receptor in critical ill patients with stress hyperglycemia and the effect of intensive glucose control on it.Methods Nineteen adult patients were admitted to surgical intensive care unit(SICU)and randomly assigned into two groups:intensive glucose controlled group(to control glucose at 4.4-6.7 mmol/L)and hyperglycemia group(to control glucose at 8.3-10.0 mmo]/L).Blood glucose Was controlled with using continuing insulin infusion.The

expression

of

insulin

receptors(InsR)of

pefipheral

erythrocyte was detected by radioligand assay methods on the morning of day1,2,4,7 after admitted to SICU.Daily usage of insulin and APACHE Ⅱ score were recorded.The correlation of number and affinity constant of erythrocyte insulin receptors with daily dosage of insulin and APACHE Ⅱ were analyzed Results The number and affinity constant of erythrocyte insulin reeeptors was decreased significantly in day 1 and 2 in both groups,and recovered gradually in day 4 and 7,and significant difierence was found between the patients with APACHEⅡ≥15 and those with APACHE Ⅱ＜15.The number and affinity constant of erythrocyte insulin receptor recovered more quickly in intensive glucose