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目的探讨胰岛素强化治疗对严重创伤患者血清蛋白的影响。方法80例严重创伤患者按随机配对原则分为胰岛素强化治疗组(40例)和对照组(40例)。强化治疗组进行胰岛素强化治疗,对照组进行临床常规治疗,在强化或常规治疗前,治疗开始后1、3、7、10、14、21 d检测血清白蛋白(AL)、前白蛋白(PA)、视黄醇结合蛋白(RBP)和糖化血清蛋白(FMN)含量。结果2组患者伤后AL、PA、RBP水平均出现显著下降然后逐渐恢复过程,但AL伤后10 d强化组明显高于对照组(P<0.05),PA伤后7 d强化组明显高于对照组(P<0.05),RBP伤后3 d强化组明显高于对照组(P<0.05)。FMN伤后早期无明显变化,14 d后有所升高,但强化组明显低于对照组。结论胰岛素强化治疗通过降低严重创伤患者的应激性高血糖,有助于血清蛋白的恢复和营养状态的改善。
Objective To investigate the effect of intensive insulin therapy on serum proteins in patients with severe trauma. Methods Eighty patients with severe trauma were divided into three groups according to random matching: intensive insulin treatment (40 cases) and control group (40 cases). Intensive treatment group was treated with intensive insulin therapy. The control group was given routine clinical treatment. Serum albumin (AL) and prealbumin (PA) were measured before intensive treatment or routine treatment at 1, 3, 7, ), Retinol binding protein (RBP) and glycated serum protein (FMN) content. Results The levels of AL, PA and RBP significantly decreased and then gradually recovered in the two groups. However, the levels of AL and PA and RBP in the two groups were significantly higher than those in the control group (P <0.05) The control group (P <0.05), RBP 3 d after injury group was significantly higher than the control group (P <0.05). There was no obvious change in the early stage of FMN injury, but it increased after 14 days, but was significantly lower in the intensive group than in the control group. CONCLUSION: Intensive insulin therapy helps to restore serum protein and improve nutritional status by reducing stress hyperglycemia in severely traumatized patients.