颅脑损伤与胰岛素抵抗的相关性研究

目的分析颅脑损伤的严重性、血糖与胰岛素水平三者之间的关系。方法92例颅脑损伤患者按入院时GCS评分分为轻度、中度及重度颅脑损伤三组，分别于伤后24h、48h、72h测定空腹血糖、血清胰岛素值，并计算稳态模式中的胰岛素抵抗指数（HOMA—IR）。患者出院时按GOS标准评估预后。采用SPSS11．5统计软件对数据进行处理，分析GCS、空腹血糖、胰岛素水平的关系。结果出院时按GOS标准．良好72例，差12例，死亡8例．死亡率8．7％。92例颅脑损伤患者伤后连续3d空腹血糖及胰岛素水平在轻度、中度、重度颅脑损伤三组患者中有显著差异（P〈0．01或P〈0．05）。颅脑损伤程度越重．血糖和HOMA—IR越高。结论空腹血糖值和HOMA—IR值可作为评估颅脑损伤严重程度的参考指标。

Study of Relativity between Head Injury and Insulin Resistance

Objective To analyze relationship among the severity of head injury, change in blood glucose and serum insulin level. Methods In this study 92 patients with head injury were divided into three groups (mild, moderate and severe head injury groups) according to the severity of head injury. The fasting blood glucose (FBG) levels and fasting insulin levels (FIL) were determined 24, 48, and 72 hours respectively after the injury. The homeostasis model of assessement insulin resistance (HOMA-IR) was calculated. The prognosis was estimated according to GOS in all the patients when they were discharged from hospital. The datums of all the patients were processed by SPPS 11.5 statistical software. The relationship among GCS, FBG and FIL was analysed. Results According to GOS, of 92 patients with head injury, 72 had good outcome, 12 bad and 8 died (8.7%). There were significant differences in FBG and FIL among the mild, moderate and severe head injury groups (P<0.01 or P<0.05). The more severe the head injury is, the higher the values of FBG and HOMA-IR are in the patients with head injury. Conclusion It is suggested that the FBG level and HOMA-IR may serve as the refernce indexes of estimating head injury severity in patients with head injury.