Johan Groeneveld A B, Beishuizen Albertus, Visser Frans C
Department of Intensive Care, Institute of Cardiovascular Research, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
Crit Care. 2002 Apr;6(2):102-5. doi: 10.1186/cc1463. Epub 2002 Feb 8.
Stress hyperglycaemia is a common event in acute critical illness. There is increasing evidence that maintaining normoglycaemia and treatment with insulin (or with glucose-insulin-potassium [GIK]), even in non-diabetic persons, is helpful in limiting organ damage after myocardial infarction, stroke, traumatic brain injury and other conditions, even though the conditions may be accompanied by insulin resistance. A landmark study now suggests that maintaining normoglycaemia with intensive insulin treatment in a heterogeneous population of critically ill patients decreases morbidity and mortality. The potential mechanisms that underlie such a beneficial effect are discussed.
应激性高血糖是急性危重病中的常见现象。越来越多的证据表明，即使在非糖尿病患者中，维持血糖正常以及使用胰岛素（或葡萄糖 - 胰岛素 - 钾 [GIK]）治疗，有助于限制心肌梗死、中风、创伤性脑损伤及其他疾病后的器官损伤，尽管这些疾病可能伴有胰岛素抵抗。一项具有里程碑意义的研究表明，在危重症患者的异质性群体中，强化胰岛素治疗维持血糖正常可降低发病率和死亡率。文中讨论了这种有益作用的潜在机制。
