胰岛素强化治疗对急性胰腺炎患者血清炎症因子水平的影响

目的探讨胰岛素强化治疗对急性胰腺炎患者血清炎症因子的影响。方法79例未合并糖尿病的急性胰腺炎患者随机分为常规治疗组（n=39）和胰岛素强化治疗组（n=40）。常规组使用常规药物治疗；胰岛素强化治疗组在常规治疗基础上加用胰岛素治疗，将血糖维持在4.4-6、1mmol／L。分剐于治疗前和治疗24、72h抽血测定IL-6及超敏c反应蛋白（CRP）水平。同时设70例正常健康人群用于分析比较。用酶联免疫吸附法检测IL-6，用免疫比浊法测定cRP。结果①与健康对照组相比，急性胰腺炎患者外周血IL-6（58．7±9．6ng／Lvs．6．4±2．4ng／L，P〈0．01）和CRP（118．1±13．2mg/L VS．2．7±1．1mg／L，P〈0．01）均有显著性升高。②外周血IL-6（18．4±6．2ng／L vs．60．7±10．1ng／L，P〈0．01）、cRP的水平（15．6±6．3mg／L VS．121．1±14．3mg／L，P〈0．01）在胰岛素强化治疗72h后有显著性降低。结论胰岛素强化治疗可降低急性胰腺炎患者血清IL-6和CRP的炎症因子水平。

Effects of insulin intensive therapy on blood inflammatory cytokines levels in non-diabetic acute pancreatitis patients.

Objective To investigate the effects of insulin intensive therapy on blood inflammatory cytokines levels in non - diabetic acute pancreatitls patients. Methods Seventy - nine patients without diabetic acute pancreatitis were randomly divided into conventional group consisted of 39 cases treated with conventional therapy and insulin intensive therapy group consisted of 40 cases treated with conventional therapy plus insulin. The levels of serum IL - 6 and CRP were determined before treatment and 24 and 72 hours after intervention. Meawhile 70 healthy persons were enrolled as controls. The level of IL - 6 was determined with ELISA and that of CRP with immune turbidimetry. Results 1 ） Compared with healthy controls, the levels of serum IL - 6 （ 58.7±9.6ng/L vs. 6.4± 2.4ng/L, P 〈 0.01 ） and CRP （ 118.1±13.2mg/L vs. 2.7±1.1mg/L, P 〈 0.01 ）in patients without diabetic acute pancreastltis were significantly higherr; 2 ） The levels of peripheral IL- 6 and CRP in patients of insulin intensive therapy group were significantly reduced compared with control group （ P 〈 0.05 ）. Conclusion The levels of CRP and IL-6 in patients without diabetic acute panereastitis are reduced as compared to the healthy controis and treatment with insulin intensive therapy is beneficial for the above eytokines.