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目的:研究重型颅脑损伤患者肠外营养致高血糖对血清热休克蛋白27(HSP27)抗体表达的影响。方法:将2013年9月到2014年12月我科ICU收治的重型颅脑损伤行肠外营养致高血糖的31例患者随机分为胰岛素强化治疗组(IIT组,n=16)及常规血糖控制组(CGC组,n=16),其至少50%的估计能量需要量(EER)由肠外营养获得。比较两组入ICU时、第7 d和第14 d血清抗HSP27抗体浓度。结果:IIT组血清HSP27抗体浓度第14d较GCG组明显下降(P<0.05)。结论 :胰岛素强化治疗可通过降低血清中HSP27抗体而减轻接受肠外营养的重型颅脑损伤患者的神经元应激。
Objective: To study the effect of parenteral nutrition-induced hyperglycemia on the expression of serum heat shock protein 27 (HSP27) antibody in patients with severe craniocerebral injury. Methods: From September 2013 to December 2014, 31 patients with severe craniocerebral injury who underwent parenteral nutrition-induced hyperglycemia were randomly divided into insulin-intensive treatment group (IIT group, n = 16) and conventional blood glucose Controlled group (CGC group, n = 16), at least 50% of estimated energy requirements (EER) were obtained from parenteral nutrition. When comparing the two groups into the ICU, serum anti-HSP27 antibody concentrations on the 7th and 14th days were compared. Results: Serum HSP27 antibody concentration in IIT group was significantly lower than that in GCG group on the 14th day (P <0.05). CONCLUSION: Intensive insulin therapy can reduce neuronal stress in patients with severe craniocerebral injury undergoing parenteral nutrition by reducing HSP27 in serum.