Little R A, Henderson A, Frayn K N, Galasko C S, White R H
North Western Injury Research Centre, University of Manchester, U.K.
Acta Anaesthesiol Belg. 1987;38(4):275-9.
Whole body glucose uptake and oxidation during a hyperglycemic clamp have been shown to be depressed in hypermetabolic septic patients compared to control subjects despite similar plasma insulin concentrations. Forearm glucose uptake was similarly impaired. Metabolic rate was not increased further by the glucose infusion in the patients although a 20% rise was elicited in the controls. This resistance to the effects of insulin was also clearly demonstrated in trauma patients using the euglycemic clamp technique. The maximal rate of glucose disposal after injury was half that found in controls and the pattern of response was consistent with the insulin resistance being a post-receptor defect.
与对照组相比，尽管血浆胰岛素浓度相似，但在高代谢脓毒症患者中，高血糖钳夹期间的全身葡萄糖摄取和氧化已显示出降低。前臂葡萄糖摄取也同样受损。尽管对照组中葡萄糖输注引起了20%的升高，但患者的葡萄糖输注并未使代谢率进一步增加。使用正常血糖钳夹技术在创伤患者中也清楚地证明了这种对胰岛素作用的抵抗。损伤后葡萄糖处置的最大速率是对照组的一半，并且反应模式与胰岛素抵抗是受体后缺陷一致。
