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观察地塞米松在重症病人应激反应中的作用，在此报道４０例重症感染手术病人血浆皮质醇、胰岛素和血糖的变化以及地塞米松对它们的影响。用药前，所有病人血浆皮质醇、胰岛素和血糖均明显高于正常（Ｐ＜０．０５）。滴入地塞米松０．３ｍｇ·ｋｇ－１后，皮质醇稳定，血糠水平明显下降，而对照组则持续升高，胰岛素水平两组变化相仿。提示，重症感染病人早期使用地塞米松可以改变皮质醇水平，降低血糖，纠正胰岛素和血糖间的“不协调”，有利于减轻机体的应激反应，对改善病人预后有利。
To observe the role of dexamethasone in the stress response of critically ill patients. The changes of plasma cortisol, insulin and blood glucose and the effect of dexamethasone on 40 patients with severe infections were reported here. Before treatment, all patients with plasma cortisol, insulin and blood glucose were significantly higher than normal (P <0.05). After instillation of dexamethasone 0.3mg · kg-1, cortisol was stable and the level of blood bran decreased significantly, while the control group continued to rise, the changes of insulin level in two groups were similar. These results suggest that the early use of dexamethasone in patients with severe infection can change the level of cortisol and blood glucose, and correct the “incongruity” between insulin and blood glucose, which is helpful to reduce the body’s stress response and improve the prognosis of the patients.