吲哚美辛对感染病人糖代谢及胰岛素敏感性的影响

探讨吲哚美门牌对感染病人糖代谢及仰望同素敏感性的影响。选择严重腹腔感染病人，ＡＰⅡ〉１０分，血糖〉１０ｍｍｏｌ／Ｌ，序贯分为两组：对照组８例；吲哚美辛组７例，两组病人皆在静脉输液中加入普通胰岛素约３２Ｕ／ｄ（胰岛素：葡萄糖＝１：４）。吲哚美且吲哚美辛栓纳肛，１００ｍｇ／ｄ，于实验开始前１天及第５天，分别采取标本和作项目测定。测定空腹血糖，肌酐、尿素氮、三酰甘油、游离脂肪酸浓度。应用间接能量测定仪测

EFFECT OF INDOMETHACIN ON THE GLYCOMETABOLISM AND THE SENSITIVITY OF INSULIN IN PATIENTS WITH INFECTION

To study the effect of indomethacin on insulin sensitivity and glycometabolism. Patients with severe intraabdominal infection(APACHE II score >10, glucose concentration >10 mmol/L) were selected and divided into two groups: Control( n =8) and INDO( n =7) groups. Patients in both groups were infused with insulin (32U/d), whereas indomethacin was put into rectum (100mg/d) of INDO patients. Samples and assessment were taken on d0 and d5, fasting blood glucose ,Cr ,BUN,TG,FFA were assayed and energy expenditure ,substrates oxidation rate were measured by indirect calorimetry, and insulin tolerance test was made on d5. Five days after insulin infusion , blood Cr, BUN, TG,FFA decreased and glucose oxidation rate increased to some degree in patients of both groups, but they were significantly higher on d1 than d5 in INDO group ( P <0.05). No antihyperglycemia effect of insulin infusion was found in septic patients, whereas significant reduction was found in blood glucose ( P <0.05). Result of insulin tolerance test showed that glucose decreased significantly after insulin injection in INDO group ,which had a higher KI value than that in control group. CONCLUSIONS Indomethacin could enhance insulin sensitivity, promote glucose utilization and improve glucose metabolism in severe septic patients.