Dandona Paresh, Chaudhuri Ajay, Ghanim Husam, Mohanty Priya
Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, New York, USA.
Rev Cardiovasc Med. 2006;7 Suppl 2:S25-34.
Hyperglycemia worsens morbidity and mortality for patients in intensive care or with acute myocardial infarction, stroke, or coronary artery bypass grafts. The control of hyperglycemia with insulin improves clinical outcomes for patients with these conditions. This article reviews the anti-inflammatory effects of insulin and pro-inflammatory effects of glucose and free fatty acids, and provides a mechanistic justification for maintaining euglycemia with insulin infusions. Hyperglycemia induced by infusions of a fixed dose of insulin with high rates of glucose may neutralize the benefit of insulin, and such regimens should be replaced by infusion of insulin to restore and maintain euglycemia.
高血糖会加重重症监护患者或患有急性心肌梗死、中风或冠状动脉搭桥手术患者的发病率和死亡率。使用胰岛素控制高血糖可改善这些患者的临床结局。本文综述了胰岛素的抗炎作用以及葡萄糖和游离脂肪酸的促炎作用，并为通过胰岛素输注维持血糖正常提供了机制依据。输注固定剂量胰岛素并同时大量输注葡萄糖所导致的高血糖可能会抵消胰岛素的益处，此类治疗方案应被胰岛素输注所取代，以恢复并维持血糖正常。
