Desai D, March R, Watters J M
Department of Surgery, University of Ottawa, Ontario, Canada.
J Trauma. 1989 Jun;29(6):719-23. doi: 10.1097/00005373-198906000-00003.
The metabolic responses to trauma and surgery have been well described and are observed most typically in otherwise healthy young and middle-aged individuals. To investigate the effect of age on blood glucose, insulin, and cortisol responses after mild to moderate trauma, we studied 33 patients (Injury Severity Scores, 5-38, and ages 16 to 81 years) before resuscitation and 24-96 hours postinjury. Age was associated with an increase in serum glucose during both "ebb" and "flow" phases of the injury response, but not with serum insulin. Serum glucose also increased with the degree of injury as reflected in Glasgow Coma Scale on admission and Injury Severity Score subsequently. Serum cortisol responses were increased in older patients and tended to decrease with time following injury. A more detailed knowledge of how age may alter the ability of elderly patients to respond to trauma and critical illness is essential to allow the continued development of rational therapies for such patients.
对创伤和手术的代谢反应已有充分描述，最典型的是在其他方面健康的年轻和中年个体中观察到。为了研究年龄对轻度至中度创伤后血糖、胰岛素和皮质醇反应的影响，我们在复苏前以及受伤后24 - 96小时对33例患者（损伤严重度评分5 - 38分，年龄16至81岁）进行了研究。年龄与损伤反应的“潮退”和“潮涌”阶段血清葡萄糖升高相关，但与血清胰岛素无关。血清葡萄糖也随着损伤程度增加，这在入院时的格拉斯哥昏迷量表以及随后的损伤严重度评分中有所体现。老年患者的血清皮质醇反应增加，且受伤后随时间有下降趋势。更详细地了解年龄如何改变老年患者对创伤和危重病的反应能力，对于持续开发针对此类患者的合理治疗方法至关重要。
