危重症患儿胰岛素抵抗与心肌损害的临床相关性

发布时间：2019-06-19 10:39

【摘要】：目的：危重症患儿多伴明显的胰岛素抵抗和心肌损害。本研究探讨危重症患儿胰岛素抵抗与心肌损害的关系。方法：选取2010年3月至2011年6月住院治疗的危重症患儿63例为病例组，均测定空腹血糖（FBG）、血清胰岛素水平（FINS）及心肌酶（LDH、CK、CK-MB、AST、α-HBDH）、肌钙蛋白I（CTnI），同时计算胰岛素抵抗指数（HOMA-IR）。HOMA-IR＞1.0者归入胰岛素抵抗组（30例），，HOMA-IR≤1.0者（33例）归入非胰岛素抵抗组。同时选取健康儿童30例作为对照组。结果：胰岛素抵抗组胰岛素抵抗指数（HOMA-IR）、乳酸脱氢酶（LDH）、门冬氨酸氨基转移酶（AST）、肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、α-羟丁酸脱氢酶（α-HBDH）、肌钙蛋白I（CTnI）水平均明显高于非胰岛素抵抗组及对照组，差异有统计学意义（P＜0.05）；非胰岛素抵抗组LDH、AST、CK、CK-MB、α-HBDH、CTnI水平明显高于对照组，差异有统计学意义（P＜0.05）。胰岛素抵抗组HOMA-IR与LDH、CK、CK-MB、AST、α-HBDH、CTnI水平呈正相关（分别r=0.697,0.739,0.781,0.642,0.381,0.792, P＜0.05）。结论：胰岛素抵抗可以加重心肌损害，HOMA-IR可以作为心肌损害程度的预测指标。
[Abstract]:Objective: To study the effect of insulin resistance and myocardial damage in critically ill children. Objective To study the relationship between insulin resistance and myocardial damage in critically ill children. Methods: The fasting blood glucose (FBG), serum insulin level (FINS), and myocardial enzymes (LDH, CK, CK-MB, AST, HCO3-HBDH) and troponin I (CTnI) were measured in 63 children with severe and severe children hospitalized from March 2010 to June 2011. At the same time, the insulin resistance index (HOMA-IR) was calculated. HOMA-IR> 1.0 was included in the insulin resistance group (30 cases), and the HOMA-IR> 1.0 (33 cases) was included in the non-insulin resistance group. At the same time,30 healthy children were selected as control group. Results: The insulin resistance index (HOMA-IR), the lactate dehydrogenase (LDH), the aspartate aminotransferase (AST), the creatine kinase (CK), the creatine kinase isoenzyme (CK-MB), the L-hydroxybutyric acid dehydrogenase (HCO3-HBDH), The levels of serum cardiac troponin I (CTnI) were significantly higher in the non-insulin resistance group than in the control group (P <0.05). The levels of LDH, AST, CK, CK-MB, HCO3-HBDH and CTnI in the non-insulin resistance group were significantly higher than those in the control group (P <0.05). The HOMA-IR of the insulin resistance group was positively correlated with the levels of LDH, CK, CK-MB, AST, HCO3-HBDH and CTnI (r = 0.697, 0.739, 0.781, 0.642, 0.381, 0.792, P <0.05). Conclusion: Insulin resistance can aggravate the myocardial damage, and the HOMA-IR can be used as the prediction index of the degree of myocardial damage.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R720.597

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