创伤；C肽；细胞间黏附分子1；胰岛素抵抗_

C肽、细胞间黏附分子、胰岛素抵抗与创伤急性期的相关研究

http://www.100md.com 《创伤外科杂志》 2006年第6期

创伤；C肽；细胞间黏附分子1；胰岛素抵抗,,创伤；C肽；细胞间黏附分子1；胰岛素抵抗,1一般资料,2方法,参考文献：

     摘要：目的探讨创伤患者急性期C肽(CP)、细胞间黏附分子1(ICAM1) 、胰岛素抵抗(IR)的变化特点及其临床意义。方法创伤住院患者55例，分别于伤后24小时内、3、7天取静脉血，采用放射免疫法测定血清C肽(CP)及空腹胰岛素(FINS)，酶联免疫吸附法测定ICAM1、终点法测定果糖胺(FMN)，GODPAP法测定空腹血糖(FPG)等数值，按1∕(FPG×FINS)计算出胰岛素敏感性指数(IAI),观察不同时间段各值的变化特点并与正常对照组进行比较。结果 (1)创伤患者在伤后24小时内CP、ICAM1即显著升高，IAI显著降低，与正常对照组相比，差异显著(P<0.01~0.001)；(2)伤后3天与正常对照组相比，CP仍增高，IAI降低，差异显著(P<0.01~0.001)；(3)伤后7天，除CP外，其余指标趋于正常；(4)创伤后FMN与对照组相比无差异(P>0.05)。结论创伤急性期患者存在应激引起的糖代谢紊乱及炎性损伤,监测CP、ICAM1、IR等指标对指导临床治疗、判断预后有一定的意义。

    关键词：创伤；C肽；细胞间黏附分子1；胰岛素抵抗

    Relationship of Cpeptide,intercellular adhesion molecular1 and insulin resistance with traumatic acute stage

    ZHOU Guangyong,WANG Xiaoyun,LI Xu,et al.

    (Department of Truamtic Surgery,Third People's Hospital of Guiyang,Guiyang 550006,China)

    Abstract： Objective To investigate the change and clinical value of Cpeptide (CP),intercellular adhesion molecular1(ICAM1),insulin resistance of traumatic patients.Methods Venous blood of 55 traumatic cases admitted in our hospital were taken and tested on 24 hours,3 days and 7 days after being injured: CP and fasting serum insulin (FINS),ICAM1,fructosamine (FMN),fasting serum glucose(FBG)were tested by radioimmunoassay,ELISA,endpoint method and GODPAP method respectively.Insulin acuity index (IAI) was figured out according to ‘IAI=1∕(FPG×FINS)’ and the change of the data obtained on different time periods was observed and compared with the those of the control group.Results (1)In 24 hours,CP、ICAM1 of the traumatic patients rose markedly,IAI reduced notably as compared with control group(P<0.010.001).(2)After 3 days,CP kept rising and IAI still reduced.There was significant difference between the CP and IAI of the patients and control group(P<0.010.001).(3)After 7 days,all the indexes except CP tented to return to normal value.(4)There was no significant difference between the FMN of the patients after injury and control group(P>0.05).Conclusion The patients in traumatic acute stage show disturbance of carbohydrate metabolism which is caused by stress and inflammatory damage. ......

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