【摘要】：目的觀察重癥感染合并應(yīng)激性高血糖患者短期強(qiáng)化血糖控制的臨床效果。方法76例重癥感染合并應(yīng)激性高血糖患者隨機(jī)分為對(duì)照組(n=38)和強(qiáng)化治療組(n=38)。比較入院1 d及7 d后2組外周血中炎性因子水平及T細(xì)胞亞群水平,觀察入院第1、3、7天2組患者血糖濃度(FPG)、血糖變異性(GV)及血糖達(dá)標(biāo)時(shí)間(TT)等情況。結(jié)果入院后7 d強(qiáng)化治療組患者的CRP、IL-6、TNF-α水平明顯低于同期對(duì)照組(P0.05),也低于入院第1天水平(P0.05);強(qiáng)化治療組患者外周血淋巴細(xì)胞中的CD4~+細(xì)胞及CD4~+/CD8~+細(xì)胞比例顯著高于對(duì)照組(P0.05),同時(shí)均高于入院第1天水平(P0.05);入院第3、7天強(qiáng)化治療組患者FPG、GV及TT明顯低于對(duì)照組(P0.05);Logistic回歸分析顯示,入院時(shí)APACHEⅡ評(píng)分和GV可作為結(jié)局預(yù)測(cè)的重要指標(biāo)。結(jié)論短期強(qiáng)化血糖控制能提高重癥感染合并應(yīng)激性高血糖患者免疫功能并改善預(yù)后。
[Abstract]:Objective to observe the clinical effect of short-term intensive blood glucose control in severe infection with stress hyperglycemia. Methods 76 patients with severe infection complicated with stress hyperglycemia were randomly divided into control group (n = 38) and intensive treatment group (n = 38). The levels of inflammatory cytokines and T cell subsets in peripheral blood of the two groups were compared 1 d and 7 d after admission, and the blood glucose concentration (FPG), blood glucose variability (GV) and blood glucose standard time (TT) of the two groups were observed on the 1st and 7th day after admission. Results the level of CRP,IL-6,TNF- 偽 in the intensive treatment group was significantly lower than that in the control group at 7 days after admission (P0.05) and the level on the first day of admission (P0.05). The proportion of CD4~ cells and CD4~ / CD8~ cells in peripheral blood lymphocytes in intensive treatment group was significantly higher than that in control group (P0.05) and higher than that in the first day of admission (P0.05). The FPG,GV and TT in the intensive treatment group were significantly lower than those in the control group on the 3rd day of admission (P0.05); Logistic regression analysis showed that APACHE 鈪，

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