摘要
目的 观察动脉导管结扎术过程中糖代谢改变 ,探讨胰岛素抵抗产生的机制。方法 8例动脉导管结扎术患者 ,于麻醉前、麻醉后、开胸后 2 0分钟、术毕、术后 6小时采取血样 ,测定血糖、胰岛素、C 肽、乳酸、TNF α的浓度 ,并于手术开始即刻、术毕关胸即刻取骨骼肌标本 ,测定骨骼肌细胞膜胰岛素受体酪氨酸蛋白激酶 (TPK)活性的变化。结果 术毕、术后 6小时血糖、C 肽均分别显著高于麻醉前的对照值 (P <0 0 1) ,胰岛素、乳酸、TNF α则无明显变化。血糖与胰岛素乘积 (Gs×Ins)亦显著升高 (P <0 0 1)。手术前后骨骼肌细胞膜胰岛素受体TPK活性以及对胰岛素刺激的反应性均无明显改变。
Objective To observe the perioperative changes in glucose metabolism in children underwent ligation of patent ductus arteriosus(PDA) and investigate the mechanism of insulin-resistance.Methods Blood samples were obtained before anesthesia,after anesthesia,at 20min after opening thorax,the end of operation,6h after operation.Glucose,Insulin,C-P,Lactate as well as TNF-α were measured.The skeletal muscle samples were obtained at the beginning and the end of operation.Then the activity of insulin receptor tyrosine protein kinase of skeletal muscle were measured.Results Plasma glucose and C-P were significantly increased after operation compared with those before operation.No significant changes of plasma insulin,lactate and TNF-α were observed.The value of Gs×Ins elevated significantly.No significant changes in activity of insulin receptor tyrosine protein kinase and its sensitivity to insulin stimulation in the skeletal muscle were observed.Conclusion The insulin resistance observed at the end of operation and 6h after operation seems not to be related to the TPK activity of the insulin receptor.
出处
《临床麻醉学杂志》
CAS
CSCD
2002年第9期473-475,共3页
Journal of Clinical Anesthesiology
