果糖对鼻腔手术后患者血糖和胰岛功能影响的双盲随机对照研究-_医学论文.docVIP

果糖对鼻腔手术后患者血糖和胰岛功能影响的双盲随机对照研究-_医学论文 果糖对鼻腔手术后患者血糖和胰岛功能影响的双盲随机对照研究*_医学论文 王晓云，黄魏宁，殷萍华，王利一，杨 弋，刘 芳 【摘要】 目的 评价果糖对鼻腔手术后患者血糖和胰岛功能的影响。方法 采用前瞻、随机、双盲和对照的研究方法，选择满足方案入选标准并获得知情同意的鼻腔手术后患者共60例进入本研究。术后1～2天开始空腹静脉注射5%果糖注射液或5%葡萄糖注射液500ml，连续3天。观察用药前和用药中血糖和胰岛素、胰岛素C的变化，比较两组之间的差别。同时观察用药中血尿酸和乳酸。结果 按计划完成本研究60例，无淘汰病例；两组在输液前后血糖3天的平均变化值分别为（2.39±2.34）和（0.32±1.53）mmol/L；两组比较差异有非常显著性（0.01）。研究组输注5%的果糖注射液中，血胰岛素和胰岛素C肽的变化值分别为（7.9±21.5）μu/ml和（312±264）pmol/L；对照组相应的结果是（14.6±19.8）μu/ml和（524±212）pmol/L，对照组输注葡萄糖胰岛素和C肽升高的幅度显著大于研究组，差异有显著性（0.05）；输注果糖注射液中两组的血乳酸和尿酸结果相似。结论 适量静脉输注果糖对手术后患者血糖和胰岛功能的影响较小。 【关键词】 果糖；外科手术；血糖；胰岛；随机对照试验 【Abstract】 Objective To evaluate the effects of fructose on serum glucose and pancreas islet function in post nasal cavity operation patients.Methods It is a prospective，double，randomized and controlled clinical study.60 consented post nasal cavity operation patients who met with defined criteria were control into the study.The subjects in study group were administered with 500ml 5% fructose injections intravenously in a series of three days since postoperation 1st or 2nd day；it was administered with 5% glucose in control group.The changes of serum glucose，INS and INS C，lactic acid and uric acid，before and after injection were measured；adverse events were observed.Results We had achieved 60 cases according to the study protocol.The effects of intravenous injection of 5% fructose 500ml of on serum glucose were relatively mild.After the injection，the changes of serum glucose were (0.32±1.53)mmol/L；however the serum glucose increased remarkably in control group，in which the changes of serum glucose were (2.39±2.34)mmol/L.The difference between 2 groups was significant (0.01).In study groups，the changes of insulin and insulin peptide C were mild；while in control group，the parameters described above increased remarkably.The differences between 2 groups were significant (0.05).No effect on serum lactic acid and uric acid was observed in all groups.No adverse event was reported.Conclusion Adeq