重庆医学2017，Vol.46Issue(29)：4063-4066,4.DOI:10.3969/j.issn.1671-8348.2017.29.010
严重创伤失血多器官功能不全综合征患者胰岛β细胞功能与感染炎症和主要脏器功能的相关性
Relationships between islet β-cell function and infection,inflammation and major organ function in multiple organ dysfunction syndrome patients with severe traumatic hemorrhage
摘要
Abstract
Objective To analyse the relationships between islet β-cell function and infection,inflammation and major organ function in multiple organ dysfunction syndrome (MODS) patients with severe traumatic hemorrhage.Methods A total of 187 cases of MODS patients hospitalized in the 94th Hospital of PLA from January 2013 to January 2016 were selected,and were divided into the MODS survival group (MODS-S group,104 cases) and MODS dead group (MODS-D group).Other 100 healthy subjects were selected as the control group.The fasting blood glucose (GLU0) and insulin (INS0) levels,blood glucose (GLU30) and insulin (INS30) levels after 30 min of glucose loading,and levels of soluble triggering receptor expressedon myeloid cells-1 (sTREM-1),tumor necrosis factor-α (TNF-a),interleukin-6 (IL-6),alanine aminotransferase (ALT),creatinine (Cre) and creatine kinase isoenzyme (CK-MB) in different groups were determined.The insulin-β-cell function was evaluated by homeostasis model assessment of β-cell function (HOMA-β) index and ratio of insulin increment and blood glucose increment after 30 min of glucose loading (ΔINS30/ΔGLU30),and their relationships to other indexes,including sTREM-1,TNF-α,IL-6,GLU0,ALT,Cre and CK-MB,in MODS patients with severe traumatic hemorrhage were analysed.Results The HOMA-β and AINS30/AGLU30 ratio in the MODS-D group were lower than those in the MODS-S group,and levels of sTREM-1,TNF-α,IL-6,ALT,Cre and CK-MB in the MODS-D group were higher than those in the MODS-S group,there were statistically significant differences (P＜0.01).In MODS patients with severe traumatic hemorrhage,HOMA-β and ΔINS30/AGLU30 was both negatively correlated with sTREM-1,TNF-α,IL-6,GLU0,ALT,CreandCK-MB (r=-0.356 4,-0.532 1,-0.345 8,-0.772 1,-0.762 5,-0.684 8,-0.606 4;r=-0.428 5,-0.567 8,-0.487 0,-0.743 6,-0.781 7,-0.717 6,-0.640 1,P＜0.01).Conclusion MODS patients with severe traumatic hemorrhage have islet β-cell dysfunction which may be used as a prognostic and diagnostic indicator.关键词
创伤/失血/多器官功能不全/胰岛β细胞功能不全/感染/炎症/预后Key words
trauma/hemorrhage/multiple organ dysfunction/islet β-cells dysfunction/infection/inflammation/prognosis分类
医药卫生引用本文复制引用
周媛,王占科,祝仲珍,陈自力,陈文玲,刘蕊,王建东,汪仕良..严重创伤失血多器官功能不全综合征患者胰岛β细胞功能与感染炎症和主要脏器功能的相关性[J].重庆医学,2017,46(29):4063-4066,4.基金项目
江西省科技支撑基金资助项目(2008BA07400),江西省卫生计生委科技计划基金资助项目(20173025). （2008BA07400）
