本文選題：體外循環(huán) + 強(qiáng)化胰島素治療�。� 參考：《中國(guó)老年學(xué)雜志》2015年13期

【摘要】：目的探討強(qiáng)化胰島素治療對(duì)體外循環(huán)(CPB)下心臟瓣膜置換術(shù)炎性反應(yīng)的影響。方法 30例CPB下行心臟瓣膜置換術(shù)患者隨機(jī)分為強(qiáng)化胰島素組(強(qiáng)化組,n=15)和對(duì)照組(n=15)。強(qiáng)化組術(shù)中血糖控制在3.9~10.0 mmol/L,術(shù)后控制在4.4~8.3 mmol/L;對(duì)照組血糖11.1 mmol/L時(shí)給予胰島素治療。分別于麻醉誘導(dǎo)后(T0)、CPB開(kāi)始(T1)、CPB結(jié)束即刻(T2)、6 h(T3)、24 h(T4)和48 h(T5)時(shí)點(diǎn)測(cè)定血漿白細(xì)胞介素(IL)-6、腫瘤細(xì)胞壞死因子(TNF)-α濃度,并記錄術(shù)后臨床情況。結(jié)果兩組TNF-α、IL-6濃度在T2、T3、T4時(shí)點(diǎn)均明顯高于T0時(shí)點(diǎn)(P0.05);在T2、T3、T4時(shí)點(diǎn),強(qiáng)化組TNF-α、IL-6濃度明顯低于對(duì)照組(P0.05);強(qiáng)化組呼吸機(jī)支持時(shí)間明顯短于對(duì)照組(P0.05)。結(jié)論強(qiáng)化胰島素治療能降低TNF-α、IL-6濃度表達(dá),縮短呼吸機(jī)支持時(shí)間,減弱CPB引起的炎性反應(yīng)。
[Abstract]:Objective to investigate the effect of intensive insulin therapy on inflammatory response of cardiac valve replacement under cardiopulmonary bypass (CPB). Methods Thirty patients undergoing cardiac valve replacement with CPB were randomly divided into two groups: the intensive insulin group (n = 15) and the control group (n = 15). In the intensive group, the blood glucose was controlled at 3.9V 10.0 mmol / L during the operation and at 4.4 鹵8.3 mmol / L after the operation, while the control group was treated with insulin at 11.1 mmol/L. After anesthesia induction, plasma IL-6 and TNF- 偽 concentrations were measured at the beginning of T _ (1) and T _ (1) T _ (1) and T _ (2) T _ (6) T _ (3) and T _ (4) and 48 h / T _ (5), respectively, and the postoperative clinical data were recorded. The results were as follows: (1) after anesthesia induction, the plasma levels of interleukin (IL) -6 and tumor cell necrosis factor (TNF- 偽) were measured. Results the concentration of TNF- 偽 IL-6 at T2T3T4 was significantly higher than that at T0, and at T2T3T4, the concentration of TNF- 偽 IL-6 was significantly lower than that of control group (P0.05), and the time of ventilator support was shorter than that of control group (P0.05). Conclusion intensive insulin therapy can reduce the expression of TNF- 偽 IL-6, shorten the time of ventilator support, and weaken the inflammatory response induced by CPB.
【作者單位】： 川北醫(yī)學(xué)院附屬醫(yī)院麻醉科;川北醫(yī)學(xué)院附屬醫(yī)院胸心外科;
【基金】：四川省衛(wèi)生廳資助課題(No.090153)
【分類號(hào)】：R654.1

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本文編號(hào)：1941960