Dahn M, Bouwman D, Kirkpatrick J
Surgery. 1979 Sep;86(3):423-8.
Glucose intolerance has been commonly observed in sepsis and has been attributed to a multitude of endocrine and metabolic disorders. From 1977 to 1978, 19 patients were studied using intravenous glucose tolerance tests to evaluate this phenomenon; 15 patients presented with ongoing sepsis and four patients served as stress controls. Glucose intolerance was found to be a significant finding in less than 40% of the septic group. This state of intolerance was noted to be associated with a high mortality rate (60%), whereas glucose tolerance in sepsis was associated with a much improved mortality rate (10%). Hormone levels were correlated with glucose tolerance curves using the parameters of insulin, glucagon, growth hormone, cortisol, and epinephrine levels. Glucose intolerance and a high mortality rate were linked to sustained hyperglucagonemia, which was unresponsive to glucose challenge, and to marked suppression of growth hormone. This apparently represents a decompensated peripheral metabolic energy deficit, which results in the increased mortality rate.
脓毒症患者中常见葡萄糖不耐受，这归因于多种内分泌和代谢紊乱。1977年至1978年，对19例患者进行了静脉葡萄糖耐量试验以评估这一现象；15例患者患有持续性脓毒症，4例患者作为应激对照组。在不到40%的脓毒症组中发现葡萄糖不耐受是一个显著现象。这种不耐受状态与高死亡率（60%）相关，而脓毒症患者的葡萄糖耐量与死亡率显著改善（10%）相关。使用胰岛素、胰高血糖素、生长激素、皮质醇和肾上腺素水平等参数，将激素水平与葡萄糖耐量曲线进行关联。葡萄糖不耐受和高死亡率与持续的高胰高血糖素血症有关，这种血症对葡萄糖刺激无反应，还与生长激素的显著抑制有关。这显然代表了一种失代偿的外周代谢能量不足，导致死亡率增加。
