瘦素与体外循环胰岛素抵抗关系的研究.docVIP

瘦素与体外循环胰岛素抵抗关系的研究 　　作者：张拥军, 胡知朋, 聂荣华*, 陈家军, 詹波涛, 杨俊波, 张增旺 作者单位：(华中科技大学同济医学院附属襄樊医院心胸外科,湖北 襄樊 441021) 　　【摘要】 目的：探讨血瘦素浓度与体外循环(CPB)手术患者胰岛素抵抗的关系。方法：中低温体外循环手术22例，于麻醉诱导前、体外循环开始30 min、开放主动脉、体外循环开始后6、12、18、24 h抽取颈内静脉或体外循环血液，检测血糖、血清胰岛素浓度、血清瘦素浓度，计算各时间点胰岛素抵抗指数(HOMAIR)并分析它与血清瘦素浓度的关系。结果：CPB过程中、CPB术后胰岛素抵抗指数均降低;血清瘦素浓度在CPB过程中明显降低，CPB术后逐渐恢复;体外循环过程中血清瘦素浓度与胰岛素抵抗指数无明显相关性,CPB术后血清瘦素浓度与胰岛素抵抗系数呈正相关，P0.01。结论：CPB术后血瘦素浓度改变与体外循环胰岛素抵抗正相关，CPB术中胰岛素抵抗可能与血瘦素浓度的改变没有关系。 　　【关键词】 体外循环;瘦素;胰岛素抵抗 　　Study on the Relationship Between Leptin and Insulin Resistance in Patients Undergoing Cardiopulmonary Bypass ZHANG Yongjun,HU Zhipeng,NIE Ronghua*,CHEN Jiajun,ZHAN Botao,YANG Junbo,ZHANG Zengwang (Department of Cardiothoracic Surgery,Xiangfan Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Xiangfan,Hubei 441021,China) 　　Abstract：Objective To explore the relationship between leptin and insulin resistance in patients undergoing cardiopulmonary bypass(CPB).Methods Twentytwo patients were performed CPB under medium hypothermia,and blood samples were obtained at following intervals:before anesthesia induction,30 minutes after CPB,declamping of aorta,6 h after CPB,12 h after CPB,18 h after CPB,24 h after CPB.The concentrations of serum leptin,blood glucose,serum insulin were determined,respectively.The HOMAIR at every interval were calculated and its relationship with concentration of serum leptin were analyzed.Results HOMAIR were decreased both during and after CPB,the concentration of serum leptin was significantly decreased during CPB and recovered gradually after CPB,HOMAIR and the concentration of serum leptin showed no significant correlation during CPB,but they showed positive correlation after CPB(P0.01).Conclusion The change of serum leptin after CPB was positively correlated with insulin resistance after CPB,the change of insulin resistance during CPB may have no relationship with the change of serum leptin concentration. 　　Key wor