临床儿科杂志 ›› 2015, Vol. 33 ›› Issue (6): 543-.doi: 10.3969 j.issn.1000-3606.2015.06.011

• 综合报道 • 上一篇    下一篇

胰岛素样生长因子-I 和血糖在脓毒症中的变化及意义

田杨,朱翠平,洪婕,黄怡玲,麦坚凝   

  1. 广州市妇女儿童医疗中心( 广东广州 510623)
  • 收稿日期:2015-06-15 出版日期:2015-06-15 发布日期:2015-06-15
  • 通讯作者: 朱翠平 E-mail:zndxy3@gmail.com
  • 基金资助:
    广州市科技局科技支撑项目(No. 2008Z1-E291)

The variation of insulin like growth factor-I and glucose and correlation in children with sepsis

TIAN Yang, ZHU Cuiping, HONG Jie, HUANG Yiling, MAI Jianning   

  1. Guangzhou Women and Children’s Medical Center, Guangzhou 510623, Guangdong, China
  • Received:2015-06-15 Online:2015-06-15 Published:2015-06-15

摘要: 目的 探讨脓毒症患儿血清胰岛素样生长因子-I(IGF-I)和血糖的变化及相关意义。方法 选择2009年1月至2010年1月入住PICU的脓毒症患儿42例,检测入院次日清晨血糖和血清IGF-I、皮质醇、胰岛素、IL-6、IGF结合蛋白-I(IGFBP-I)及入院第3、5天晨血清IGF-I水平,根据入院次日血糖水平分为血糖升高组和血糖正常组;以同期健康体检儿童60例为对照组,分别比较三组间各指标的差异。结果 入院次日,脓毒症血糖升高组、血糖正常组和对照组三组间血糖、IGF-I、皮质醇、胰岛素、IL-6水平的差异有统计学意义(P均<0.001),而IGFBP-I水平差异无统计学意义(P>0.05)。两两比较发现,与对照组相比,脓毒症血糖升高组和血糖正常组患儿的皮质醇、IL-6显著升高,IGF-I显著降低,差异有统计学意义(P均<0.05);血糖升高组的血糖和胰岛素水平均高于血糖正常组和对照组,差异有统计学意义(P均<0.05)。脓毒症血糖正常及血糖升高组患儿IGF-I水平随时间变化(入院次日,第3、5天)的差异无统计学意义(P均>0.05);在入院次日,第3、第5天,两组脓毒症患儿之间IGF-I水平的差异也无统计学意义(P均>0.05)。入院次日,脓毒症患儿血糖与IGF-I水平无明显相关性(r=0.152,P=0.267)。结论 脓毒症患儿IGF-I降低,并在病程中保持稳定,血糖变化与IGF-I无显著联系。

Abstract: Objective To explore the variation of insulin like growth factor-I (IGF-I) and glucose and correlation in children with sepsis. Methods Forty-two children with sepsis in pediatric intense care unit were enrolled from January 2009 to January 2010. In the morning (2nd morning) after admission, the blood glucose, serum IGF-I, cortisol, insulin, IL-6, and IGF-binding protein-I (IGFBP-1) were detected. In the 3rd and 5th morning, the serum IGF-1 was detected again. According to the blood glucose level of the 2nd morning, the children with sepsis were divided into hyperglycemia group and normal group. Meanwhile, 60 healthy children were served as control group. The data had been compared among three groups. Results In the 2nd morning, the levels of blood glucose, serum IGF-I, cortisol, insulin, and IL-6 were significantly different among three groups (all P<0.05), but the serum IGFBP-I was not significantly different (P>0.05). Compared with control group, the sepsis children with hyperglycemia and with normal blood glucose all had significantly higher serum levels of cortisol and IL-6, and significantly lower serum level of IGF-I. In the 2nd, 3rd, and 5th morning, the serum levels of IGF-1 were not significantly changed with time in sepsis children with hyperglycemia and with normal blood glucose (all P>0.05). Meanwhile, there were no significant differences in the serum levels of IGF-1 between sepsis children with hyperglycemia and with normal blood glucose in the 2nd, 3rd, and 5th morning (all P>0.05). In children with sepsis, the blood glucose and serum IGF-1 was not correlated in the next morning (r=0.152, P=0.267). Conclusions The serum level of IGF-I decreased but maintain stable in children with sepsis. The change of blood glucose may be not related with IGF-I.