切换至 "中华医学电子期刊资源库"

中华普通外科学文献(电子版) ›› 2017, Vol. 11 ›› Issue (05) : 357 -360. doi: 10.3877/cma.j.issn.1674-0793.2017.05.017

所属专题: 文献

综述

创伤应激性高血糖的机制及对策
王向文1, 马玉靖1, 张昕1, 苏国宏1, 王满才1, 张有成1,()   
  1. 1. 730030 兰州大学第二医院普外二科
  • 收稿日期:2017-05-14 出版日期:2017-10-01
  • 通信作者: 张有成
  • 基金资助:
    国家自然科学基金资助项目(051000011)

Mechanism and countermeasurement of traumatic stress hyperglycemia

Xiangwen Wang1, Yujing Ma1, Xin Zhang1, Guohong Su1, Mancai Wang1, Youcheng Zhang1,()   

  1. 1. The Second Department of General Surgery, Lanzhou University Second Hospital, Lanzhou 730030, China
  • Received:2017-05-14 Published:2017-10-01
  • Corresponding author: Youcheng Zhang
  • About author:
    Corresponding author: Zhang Youcheng, Email:
引用本文:

王向文, 马玉靖, 张昕, 苏国宏, 王满才, 张有成. 创伤应激性高血糖的机制及对策[J]. 中华普通外科学文献(电子版), 2017, 11(05): 357-360.

Xiangwen Wang, Yujing Ma, Xin Zhang, Guohong Su, Mancai Wang, Youcheng Zhang. Mechanism and countermeasurement of traumatic stress hyperglycemia[J]. Chinese Archives of General Surgery(Electronic Edition), 2017, 11(05): 357-360.

创伤应激反应引起的应激性高血糖(SHG)在临床上相当常见。SHG可导致机体代谢紊乱,加大创伤后继发感染的概率,影响机体的代谢功能并造成器官功能损害,从而严重影响创伤患者的预后,应予以积极控制。与传统应用胰岛素控制SHG血糖水平相比,胰高血糖素受体阻断剂和胰高血糖素样肽1受体激动剂所发生的血糖波动及低血糖的风险更小,本文将重点讨论胰高血糖素受体阻断剂和胰高血糖素样肽1受体激动剂治疗SHG的可能性。

Stress hyperglycemia (SHG) caused by trauma is very common in clinical practice. SHG can lead to metabolic disorders, increase the risk of secondary infection after trauma, affect the body's metabolic function and cause organ damage, which seriously affects the prognosis of trauma patients and should be actively controlled. Compared with the traditional application of insulin control SHG blood glucose levels, we will discuss the potential for glucagon receptor blockers and glucagon-like peptide-1 receptor agonists to treat SHG, with the goal of less glucose variability and hypoglycaemia than with insulin.

[1]
Barnes TM, Otero YF, Elliott AD, et al. Interleukin-6 amplifies glucagon secretion: coordinated control via the brain and pancreas[J]. Am J Physiol Endocrinol Metab, 2014, 307(10):E896-905.
[2]
Khan AS, Gibson JM, Carlson GL, et al. Protein kinetics in human endotoxaemia and their temporal relation to metabolic, endocrine and proinflammatory cytokine responses[J]. Br J Surg, 2015, 102(7):767-775.
[3]
Harp JB,Yancopoulos GD, Gromada J. Glucagon orchestrates stress-induced hyperglycaemia[J]. Diabetes Obes Metab, 2016, 18(7):648-653.
[4]
马春霞,朱瑞,李晓娟, 等. 危重症应激性高血糖患者内毒素、NO与胰岛素组分关系的研究[J]. 宁夏医学杂志, 2017, 39(1):22-24.
[5]
Rosenbaum S, Stubbs B, Ward PB, et al. The prevalence and risk of metabolic syndrome and its components among people with posttraumatic stress disorder: a systematic review and meta-analysis[J]. Metabolism, 2015, 64(8):926-933.
[6]
Roggli E, Britan A, Gattesco S, et al. Involvement of microRNAs in the cytotoxic effects exerted by proinflammatory cytokines on pancreatic beta-cells[J]. Diabetes, 2010, 59(4):978.
[7]
李峥,邹鑫森,李其斌,等. 全身炎症反应综合征评分结合血糖及C-反应蛋白变化对预后的预警作用[J]. 广西医学, 2013, 35(1):55-57.
[8]
金益,华文良,马渝. 严重创伤患者血糖水平与多器官功能不全综合征和感染的相关性分析[J]. 河北医学, 2015(4):549-551.
[9]
Marik PE, Bellomo R. Stress hyperglycemia: an essential survival response![J]. Crit Care Med, 2013, 41(6):e93-94.
[10]
黄勍栋,蔡国龙,严静, 等. 重症肺炎合并高血糖患者强化胰岛素治疗的探讨[J]. 中华医院感染学杂志, 2012, 22(10):2060-2062.
[11]
倾芝娟. ICU应激性高血糖的干预管理研究[J]. 中国医药指南, 2014(35):366-367.
[12]
李轶,徐南平. 危重症神经内分泌激素的变化[J]. 实用临床医学, 2015, 16(4):104-107.
[13]
任晓红,刘虹. 血糖控制对危重症应激性高血糖患者炎症介质表达的影响[J]. 中国药物与临床, 2014, 14(3):390-392.
[14]
Griesdale DE, de Souza RJ, van Dam RM, et al. Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data[J]. CMAJ, 2009, 180(8):821-827.
[15]
Finfer S, Liu B, Chittock DR, et al. Hypoglycemia and risk of death in critically ill patients[J]. N Engl J Med, 2012, 367(12):1108-1118.
[16]
Lazar HL. How important is glycemic control during coronary artery bypass?[J]. Adv Surg, 2012, 46(1):219-235.
[17]
李林,王长强. 胰岛素强化治疗危重创伤患者应激性高血糖的效果[J]. 天津医药, 2014(4):356-358.
[18]
张永根,贺文成,杜娜. 不同血糖控制水平与ICU危重症应激性高血糖患者预后的关系研究[J]. 江西医药, 2016, 51(7):640-642.
[19]
Jeschke MG, Klein D, Herndon DN. Insulin treatment improves the systemic inflammatory reaction to severe trauma[J]. Ann Surg, 2004, 239(4):553.
[20]
Hare KJ, Vilsboll T, Asmar M, et al. The glucagonostatic and insulinotropic effects of glucagon-like peptide 1 contribute equally to its glucose-lowering action[J]. Diabetes, 2010, 59(7):1765.
[21]
Abuannadi M, Kosiborod M, Riggs L, et al. Management of hyperglycemia with the administration of intravenous exenatide to patients in the cardiac intensive care unit[J]. Endocr Pract, 2013, 19(1):81-90.
[22]
Pinelli NR, Jones MC, Monday LM, et al. Exogenous glucagon-like peptide-1 for hyperglycemia in critically ill patients[J]. Ann Pharmacother, 2012, 46(1):124-129.
[23]
Galiatsatos P, Gibson BR, Rabiee A, et al. The glucoregulatory benefits of glucagon-like peptide-1 (7-36) amide infusion during intensive insulin therapy in critically ill surgical patients: a pilot study[J]. Crit Care Med, 2014, 42(3):638-645.
[24]
Nauck MA, Walberg J, Vethacke A, et al. Blood glucose control in healthy subject and patients receiving intravenous glucose infusion or total parenteral nutrition using glucagon-like peptide 1[J]. Regul Pept, 2004, 118(1-2):89-97.
[25]
Kelly RP, Garhyan P, Raddad E, et al. Short-term administration of the glucagon receptor antagonist LY2409021 lowers blood glucose in healthy people and in those with type 2 diabetes[J]. Diabetes Obes Metab, 2015, 17(4):414.
[26]
van Dongen MG, Geerts BF, Morgan ES, et al. First proof of pharmacology in humans of a novel glucagon receptor antisense drug[J]. J Clin Pharmacol, 2015, 55(3):298-306.
[27]
Kazda CM, Garhyan P, Kelly RP, et al. A randomized, double-blind, placebo-controlled phase 2 study of the glucagon receptor antagonist LY2409021 in patients with type 2 diabetes[J]. Diabetes Care, 2015, 39(7):1241.
[28]
Unger RH, Cherrington AD. Glucagonocentric restructuring of diabetes: a pathophysiologic and therapeutic makeover[J]. J Clin Invest, 2012, 122(1):4-12.
[29]
Guan HP, Yang X, Lu K, et al. Glucagon receptor antagonism induces increased cholesterol absorption[J]. J Lipid Res, 2015, 56(11):2183-2195.
[30]
Okamoto H, Kim J, Aglione J, et al. Glucagon receptor blockade with a human antibody normalizes blood glucose in diabetic mice and monkeys[J]. Endocrinology, 2015, 156(8):2781-2794.
[1] 张斌杰, 周丽娜. 重度烧伤患者早期应激性高血糖的危险因素及其对预后的影响[J]. 中华损伤与修复杂志(电子版), 2018, 13(03): 189-194.
[2] 王鹏, 占三辉, 柏伟华, 于海洋. 结肠癌患者腹腔镜切除术后创伤应激及微转移的改变[J]. 中华普通外科学文献(电子版), 2018, 12(05): 332-336.
[3] 孙健, 张建龙, 叶华, 朱玥, 殷子, 唐启彬, 徐鋆耀, 王捷. 胰腺中段切除术在胰腺良性及低度恶性肿瘤治疗中的应用价值[J]. 中华肝脏外科手术学电子杂志, 2013, 02(05): 302-305.
[4] 罗恒聪, 张莹. 妊娠期高血糖胰岛素应用的种类、特点和技巧[J]. 中华产科急救电子杂志, 2021, 10(01): 20-24.
[5] 余慧, 杨位霞. 非酮症性高血糖偏侧舞蹈症的临床特征并文献复习[J]. 中华诊断学电子杂志, 2022, 10(01): 26-30.
[6] 胡永雪, 夏光源, 王艺明. 非酮症高血糖偏侧舞蹈症的诊断学特征并文献复习[J]. 中华诊断学电子杂志, 2021, 09(01): 1-4.
阅读次数
全文


摘要