Objective To investigate the effects of intensive insulin therapy on inflammatory response in patients undergoing car-diopulmonary bypass.Methods 30 patients underwent valve replacement surgery were randomly assigned to intensive insulin therapy group ( IT group) and control group.Patients in IT group received a target blood glucose range of 3.9~10.0 mmol/L,and 4.4~8.3 mmol/L dur-ing and after operation,respectively.While patients in control group underwent conventional therapy when blood glucose was more than 11. 1mmol/L.IL-6,TNF-αplasma level were measured at after anesthesia induction (T0),at the beginning of CPB initiation (T1),at the end of CPB 0 h(T2),6 h(T3),24 h(T4),48 h (T5).The postoperative clinical materials were also recorded.Results The TNF-α,IL-6 plasma level at the time point of T2,T3,T4 were obviously higher than those at the time point of T0 in both groups.Compared to control group,the TNF-α,IL-6 plasma level in IT group were significantly lower at the time point of T2,T3,T4.The mechanical support time was shorter in IT group.Conclusions Intensive insulin therapy could decrease TNF-αand IL-6 level,shorten mechanical support time and attenuate the sys-temic inflammatory response effectively.%目的：探讨强化胰岛素治疗对体外循环（ CPB）下心脏瓣膜置换术炎性反应的影响。方法30例 CPB 下行心脏瓣膜置换术患者随机分为强化胰岛素组（强化组，n＝15）和对照组（n＝15）。强化组术中血糖控制在3.9～10.0 mmol／L，术后控制在4.4～8.3 mmol／L；对照组血糖＞11.1 mmol／L时给予胰岛素治疗。分别于麻醉诱导后（T0）、CPB开始（T1）、CPB结束即刻（T2）、6 h（T3）、24 h（T4）和48 h（T5）时点测定血浆白细胞介素（IL）-6、肿瘤细胞坏死因子（TNF）-α浓度，并记录术后临床情况。结果两组 TNF-α、IL-6浓度在 T2、T3、T4时点均明显高于 T0时点（P＜0.05）；在T2、T3、T4时点，强化组TNF-α、IL-6浓度明显低于对照组（P＜0.05）；强化组呼吸机支持时间明显短于对照组（P＜0.05）。结论强化胰岛素治疗能降低TNF-α、IL-6浓度表达，缩短呼吸机支持时间，减弱CPB引起的炎性反应。
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