Vanhorebeek Ilse, Langouche Lies, Van den Berghe Greet
Department of Intensive Care Medicine, Katholieke Universiteit Leuven, B-3000 Leuven, Belgium.
Novartis Found Symp. 2007;280:204-15; discussion 215-22.
Hyperglycaemia is a common feature of the critically ill and has been associated with increased mortality. Maintaining normoglycaemia with insulin therapy improves survival and reduces morbidity in prolonged critically ill patients in both surgical and medical intensive care units, as shown by two large randomized controlled studies. Prevention of cellular glucose toxicity by strict glycaemic control appears to play a predominant role, but also other metabolic and non-metabolic effects of insulin appear to contribute to the clinical benefits.
高血糖是危重症患者的常见特征,且与死亡率增加相关。两项大型随机对照研究表明,在外科和内科重症监护病房的长期危重症患者中,采用胰岛素治疗维持正常血糖水平可提高生存率并降低发病率。严格控制血糖以预防细胞葡萄糖毒性似乎起主要作用,但胰岛素的其他代谢和非代谢作用似乎也有助于产生临床益处。