伴糖尿病或应激性高血糖的重症颅脑外伤患者炎症因子与胰岛素组分的相关性

doi:10.3969/j.issn.1671-7171.2023.11.039

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摘要【目的】探讨伴糖尿病或应激性高血糖(SHG)的重症颅脑外伤患者炎症因子与胰岛素组分的相关性。【方法】回顾性分析2021年11月至2022年3月本院收治的119例伴糖代谢紊乱的重症颅脑外伤患者的临床资料,其中伴SHG的重症颅脑外伤患者58例(对照组),伴2型糖尿病(T2DM)的重症颅脑外伤患者61例(观察组)。比较两组炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]、胰岛素组分[胰岛素原(PI)、真胰岛素(TI)、免疫反应性胰岛素(IRI)]、糖代谢指标[空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)、胰岛β-细胞功能指数(HOMA-β)]水平,分析炎症因子与胰岛素组分指标的相关性,统计两组近期预后情况,分析胰岛素组分对伴糖代谢紊乱的重症颅脑外伤患者近期预后的预测价值。【结果】观察组IL-6、TNF-α、CRP、PI、IRI、FPG、HOMA-IR、HbA1c水平均高于对照组(P<0.05),HOMA-β低于对照组(P<0.05)。Pearson 相关性分析显示: IL-6、TNF-α、CRP水平与PI、IRI水平呈正相关(P<0.05)。观察组与对照组近期预后情况比较,差异无统计学意义(P>0.05)。受试者工作特征(ROC)曲线分析结果显示:PI、TI、IRI预测伴糖代谢紊乱的重症颅脑外伤患者近期预后的灵敏度分别为76.00%、52.00%、72.00%,特异度分别为75.53%、60.64%、70.21%,曲线下面积(AUC)分别为0.727、0.603、0.702。【结论】与伴SHG的重症颅脑外伤患者相比,伴糖尿病的重症颅脑外伤患者炎症反应、胰岛β-细胞功能损伤更为严重, PI、IRI明显升高,伴糖代谢紊乱的重症颅脑外伤患者炎症因子与胰岛素组分显著相关,PI预测伴糖代谢紊乱的重症颅脑外伤患者近期预后的效能较好。

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	王琳
	赵娅东

关键词 ：颅脑损伤/并发症, 糖尿病/并发症, 高血糖症/并发症, 炎症趋化因子类

收稿日期: 2023-06-26

中图分类号:

R651.15

通讯作者: * E-mail:yadong0140@126.com

引用本文:

王琳, 赵娅东. 伴糖尿病或应激性高血糖的重症颅脑外伤患者炎症因子与胰岛素组分的相关性[J]. 医学临床研究, 2023, 40(11): 1747-1750.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.11.039 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I11/1747

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