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目的:探讨极化液个体化治疗对创伤后高血糖病人促/抗炎细胞因子以及多器官功能障碍综合征(MODS)的影响,为极化液辅助治疗创伤后MODS提供实验依据。方法:将我院重症监护室收治的创伤后高血糖病人,随机分为极化液个体化治疗组(G IK组)和基础治疗组(C组)。观察不同治疗组治疗3 d后创伤病人空腹血糖、乳酸、促炎细胞因子(CRP、TNF-α和IL-1β)和抗炎细胞因子(IL-4和IL-10)水平变化以及MODS的发生率和病死率。结果:GIK组治疗3 d后,空腹血糖、乳酸、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-1β(IL-1β)水平均明显低于C组,血IL-4和IL-10水平明显高于C组。GIK组MODS的发生率明显低于C组,MODS病死率虽略有下降,但与C组比无显著差异。结论:极化液个体化治疗创伤后病人可降低促炎细胞因子和升高抗炎细胞因子水平,对控制创伤后病人的高血糖效果明显。
OBJECTIVE: To investigate the effect of individualized treatment of Polaroid fluid on the pro / anti-inflammatory cytokines and multiple organ dysfunction syndrome (MODS) in patients with post-traumatic hyperglycemia, and to provide experimental evidence for the treatment of MODS after trauma. Methods: Patients with post-traumatic hyperglycemia admitted to intensive care unit of our hospital were randomly divided into individualized treatment group (G IK group) and basic treatment group (C group). To observe the changes of fasting blood glucose, lactate, proinflammatory cytokines (CRP, TNF-α and IL-1β) and anti-inflammatory cytokines (IL-4 and IL-10) and MODS in trauma patients Rate and fatality rate. Results: The levels of fasting blood glucose, lactate, CRP, TNF-α and IL-1β in GIK group were significantly lower than those in C group after 3 days of treatment, Blood IL-4 and IL-10 levels were significantly higher than the C group. The incidence of MODS in GIK group was significantly lower than that in C group, while the mortality of MODS was slightly decreased, but no significant difference compared with C group. Conclusion: Polarized fluid individualized treatment of post-traumatic patients can reduce the level of proinflammatory cytokines and anti-inflammatory cytokines, and has obvious effect on controlling hyperglycemia in traumatic patients.