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目的:探讨ICU危重症患者的血糖浓度与血清CRP、TNF-α、IL-6及患者病重程度的关系。方法:选择40例ICU危重患者,根据患者血糖控制的程度分为A组、B组、C组,治疗后追踪观察1个月后的疗效。结果:血糖与CRP、TNF-α、IL-6水平呈正相关;三组病人血清CRP、TNF-α、IL-6经胰岛素治疗后,第7天与另外两组相比,每组患者血清中CRP、TNF-α含量有很大的差别;A组和C组患者血清中的IL-6含量差别很大,且以上差异均具有统计学意义(P<0.05)。而在血糖控制方面,A组和B组患者之间差别不大,在IL-6水平降低方面,相对于C组患者,B组患者降低较多;但上述差异均不显著(P>0.05)。A组出现MODS的发生率和病死率较B组和C组明显低(P<0.01)。血糖水平越接近正常值预后越好,比较差异均有统计学意义(P<0.05)。结论:胰岛素治疗将血糖控制于正常水平更有助于降低危重患者的炎症反应,改善患者预后。
Objective: To investigate the relationship between the serum glucose levels and the levels of serum CRP, TNF-α and IL-6 in ICU critically ill patients and the severity of the patients. Methods: Forty ICU critically ill patients were selected and divided into groups A, B and C according to the degree of glycemic control. After 1 month of follow-up, the curative effect was observed. Results: Serum glucose was positively correlated with CRP, TNF-α and IL-6. Serum CRP, TNF-α and IL-6 in three groups were significantly higher than those in the other two groups on the 7th day after insulin treatment CRP, TNF-α content of patients with a great difference; A and C patients serum IL-6 content vary greatly, and the above differences were statistically significant (P <0.05). In terms of glycemic control, there was no significant difference between group A and group B patients. In the group of patients with lower level of IL-6, the number of patients in group B decreased more than those in group C, but the above differences were not significant (P> 0.05) . The incidence of MODS and mortality in group A were significantly lower than those in group B and C (P <0.01). The closer the normal blood glucose level, the better the prognosis, the difference was statistically significant (P <0.05). Conclusion: Insulin treatment will help to control the blood sugar level in normal patients and reduce the inflammatory reaction in critically ill patients, and improve the prognosis of patients.