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目的探讨胰岛素对脓毒症患者血清Wnt5a及超氧化物歧化酶(SOD)活性的影响。方法将15例脓毒症患者随机均分为常规治疗组(A组)、常规治疗+胰岛素组(B组)和常规治疗+强化胰岛素组(C组)。入院治疗后第2、4、6、8天,采用黄嘌呤氧化酶法检测血浆SOD活性,ELISA法检测血清Wnt5a水平。结果三组Wnt5a和SOD的水平均呈时间依赖性下降。与A组相比,B、C组Wnt5a水平降低,SOD活性升高(P<0.05),C组变化过程较B组更为明显(P<0.05)。血培养阳性患者治疗后Wnt5a水平及SOD活性均高于血培养阴性患者(P<0.05)。结论使用胰岛素严格控制血糖能降低患者的病死率,改善预后;动态监测Wnt5a及SOD水平变化有助于脓毒症严重程度的判断及临床治疗。
Objective To investigate the effect of insulin on serum Wnt5a and superoxide dismutase (SOD) activity in sepsis patients. Methods Fifteen patients with sepsis were randomly divided into routine treatment group (A group), conventional therapy + insulin group (B group) and conventional therapy plus intensive insulin group (C group). On the 2nd, 4th, 6th and 8th day after admission, the activity of SOD in plasma was detected by xanthine oxidase method, and the level of serum Wnt5a was detected by ELISA. Results The levels of Wnt5a and SOD decreased in a time-dependent manner in all three groups. Compared with group A, the levels of Wnt5a and SOD in groups B and C increased (P <0.05), and the changes in group C were more obvious than those in group B (P <0.05). Wnt5a levels and SOD activity in blood-serum-positive patients after treatment were higher than those in blood-negative patients (P <0.05). Conclusions The strict control of blood sugar with insulin can reduce the mortality and improve the prognosis of patients. Dynamic monitoring of Wnt5a and SOD levels can contribute to the judgment of sepsis severity and clinical treatment.