• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Computer Methods and Programs in Biomedicine: An International Journal Devoted to the Development, Implementation and Exchange of Computing Methodology and Software Systems in Biomedical Research and Medical Practice >Impact of glucocorticoids on insulin resistance in the critically ill
【24h】

Impact of glucocorticoids on insulin resistance in the critically ill

机译：糖皮质激素对危重患者胰岛素抵抗的影响

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Glucocorticoids (GCs) have been shown to reduce insulin sensitivity in healthy individuals. Widely used in critical care to treat a variety of inflammatory and allergic disorders, they may inadvertently exacerbate stress-hyperglycaemia. This research uses model-based methods to quantify the reduction in insulin sensitivity from GCs in critically ill patients, and thus their impact on glycaemic control. A model-based measure of insulin sensitivity (SI) was used to quantify changes between two matched cohorts of 40 intensive care unit (ICU) patients. Patients in one cohort received GC treatment, while patients in the control cohort did not. All patients were admitted to the Christchurch hospital ICU between 2005 and 2007 and spent at least 24h on the SPRINT glycaemic control protocol. A 31% reduction in whole-cohort median insulin sensitivity was seen between the control cohort and patients receiving glucocorticoids with a median dose equivalent to 200. mg/d of hydrocortisone per patient. Comparing percentile patients as a surrogate for matched patients, reductions in median insulin sensitivity of 20%, 25%, and 21% were observed for the 25th-, 50th- and 75th-percentile patients, respectively. These cohort and percentile patient reductions are less than or equivalent to the 30-62% reductions reported in healthy subjects especially when considering the fact that the GC doses in this study are 1.3-4.0 times larger than those in studies of healthy subjects. This reduced suppression of insulin sensitivity in critically ill patients could be a result of saturation due to already increased levels of catecholamines and cortisol common in critically illness. Virtual trial simulation showed that reductions in insulin sensitivity of 20-30% associated with glucocorticoid treatment in the ICU have limited impact on glycaemic control levels within the context of the SPRINT protocol.
机译：糖皮质激素（GCs）已显示可降低健康个体的胰岛素敏感性。它们广泛用于重症监护，以治疗各种炎症和过敏性疾病，它们可能会无意间加重压力-高血糖症。这项研究使用基于模型的方法来量化危重患者中GC引起的胰岛素敏感性降低，从而评估其对血糖控制的影响。使用基于模型的胰岛素敏感性（SI）量度来量化40名重症监护病房（ICU）患者的两个匹配队列之间的变化。一个队列中的患者接受了GC治疗，而对照队列中的患者则没有。所有患者均于2005年至2007年之间进入克赖斯特彻奇医院ICU，并在SPRINT血糖控制方案上花费了至少24小时。对照组与接受糖皮质激素治疗的患者之间的全队列中位胰岛素敏感性降低了31％，每位患者的中位剂量相当于200. mg / d氢化可的松。比较百分位数的患者作为匹配患者的替代指标，在25％，50％和75％的患者中，中位胰岛素敏感性分别降低了20％，25％和21％。这些队列和百分位数患者的减少量小于或等于健康受试者中报告的30-62％的减少量，特别是考虑到本研究中的GC剂量是健康受试者研究中的1.3-4.0倍的事实。危重患者对胰岛素敏感性的抑制降低可能是由于危重疾病中常见的儿茶酚胺和皮质醇水平已经增加而饱和所致。虚拟试验模拟表明，在SPRINT方案的范围内，ICU中与糖皮质激素治疗相关的胰岛素敏感性降低20-30％，对血糖控制水平的影响有限。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号