作　　者： (刘敏）;

机构地区： 成都市新都区中医医院,四川成都610500

出　　处： 《海南医学院学报》 2017年第11期1559-1562,共4页

摘　　要： 目的:探讨脓毒症患儿胰岛素抵抗(IR)程度与全身炎症反应、靶器官损伤的相关性。方法:收集在本院接受治疗的脓毒症患儿70例作为观察组,同期在本院进行疫苗接种的健康小儿50例作为正常对照组,测定两组儿童的胰岛素抵抗指数(HOMA-IR),根据观察组的HOMA-IR中位数进一步将其分为高HOMA-IR组、低HOMA-IR组患儿各35例。对比不同HOMA-IR水平的脓毒症患儿全身炎症反应程度、靶器官损伤程度差异。结果:观察组的HOMA-IR水平显著高于正常对照组(P<0.05)。高HOMA-IR组血清中炎症因子PCT、IL-1β、IL-8、IL-10的含量显著高于低HOMA-IR组;血清中心肌损伤指标CK、CK-MB、LDH的含量显著高于低HOMA-IR组;血清中肝功能损伤指标ALT、AST、TBIL的含量显著高于低HOMA-IR组,ALB的含量低于低HOMA-IR组;血清中肾功能损伤指标Cr、BUN、CysC的含量显著高于低HOMA-IR组患儿(P<0.05)。结论:脓毒症患儿HOMA-IR水平较正常人高,且HOMA-IR水平与全身炎症反应、靶器官损伤程度呈正相关。 Objective：To explore the correlation of insulin resistance（IR）extent with systemic inflammatory response and target organ damage in children with sepsis.Methods：A total of 70 patients with sepsis who were treated in our hospital between June 2013 and July 2016 were collected as observation group,50 healthy children who received vaccination in our hospital during the same period were selected as normal control group,the insulin resistance index（HOMA-IR）of two groups of children were determined,the median of HOMA-IR of observation group was referred to further divide them into high HOMAIR group and low HOMA-IR group,35 cases in each group.The systemic inflammatory response and target organ damage extent were compared between sepsis children with different HOMA-IR levels.Results：HOMA-IR level in observation group was significantly higher than that in normal control group（P〈0.05）.Serum inflammatory factors PCT,IL-1β,IL-8and IL-10 contents in high HOMA-IR group were significantly higher than those in low HOMA-IR group;serum myocardial injury indexes CK,CK-MB and LDH contents were significantly higher than those in low HOMA-IR group;serum liver injury indexes ALT,AST and TBIL contents were significantly higher than those in low HOMA-IR group while ALB content was lower than that in low HOMA-IR group;serum renal injury indexes Cr,BUN and CysC contents were significantly higher than those in low HOMA-IR group（P〈0.05）.Conclusions：HOMA-IR level in children with sepsis is higher than that in normal people,and HOMA-IR level is positively correlated with systemic inflammatory response and target organ injury.

关 键 词： 脓毒症 胰岛素抵抗 全身炎症反应 心肌损伤 肝肾功能