应激性高血糖对急性百草枯中毒及其预后的影响

目的探讨应激性高血糖（SHG）在急性百草枯中毒（APP）及预后、治疗中的价值。方法采用BeckmanCX-3全自动生化分析仪电极法检测41例APP患者（其中9例痊愈、8例死亡、24例好转）入院时的血清葡萄糖含量，并选22例门诊健康检查者作对照（排除一切与应激反应有关的因素），并比较死亡患者与痊愈者血糖水平间的差异。结果41例APP患者血糖含量（7．32±2．85）mmol／L，明显高于对照组（4．314-0．50）mmol／L，差异有统计学意义（P〈0．01）。其中8例死亡者血糖含量（8．70±3．00）mmol/L亦高于9例痊愈者（7．19±2．79）mmol／L，但差异无统计学意义（P〉0．05）。41例APP合并SHG者16例，占39％。结论APP时易合并SHG，其血糖水平的高低与APP患者的预后无关，但可作为反映APP患者应激水平强弱一个有用指标，减弱持续过高的应激反应及降低高血糖，可能对病情的恢复更为有利。

Effect of the Stress Hyperglycemia on the Treatment and Prognosis of Acute Paraquat Poisoning

Objective ] To Explore the value of the Stress Hyperglycemia （SHG） on the prognosis and treatment of Acute Paraquat Poisoning （ APP ）. Methods ] On admission, the serum glucose of 41 patients （9 of them recovered, 8 cases died, 24 cases turn better） with APP was detected by automatic biochemical analyzer electrodes. The serum glucose of 22 healthy outpatients （ all rifled out with stress reaction-related factors ） was collected as the control group. The blood glucose level between the deaths and recovered patients was compared. Results]The blood glucose level （7.32±2.85mmol/L} of 41 cases with APP was higher than that （4.31± 0.50mmol/L） of the control group significantly （ P 〈 0.01 ）. The blood glucose level （ 8.70 ± 3.00 mmol/L） of 8 death cases was higher than that （7.19± 2.79mmol/L） of 9 recovered patients , but the difference was not significant （ P 〉 0.05 }. There were 16 of 41 APP cases with SHG （39%）. Conclusion] The APP complicated by SHG is common. Although the blood glucose level is unrelated with the prognosis, it is a useful indicator to reflect the stress level of APP patients. It is more beneficial for the resumption of the disease that bringing down the sustained high stress and reducing blood glucose of patients.