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目的探讨应激性高血糖(SHG)在急性百草枯中毒(APP)及预后、治疗中的价值。方法采用Beckm an CX-3全自动生化分析仪电极法检测41例APP患者(其中9例痊愈、8例死亡、24例好转)入院时的血清葡萄糖含量,并选22例门诊健康检查者作对照(排除一切与应激反应有关的因素),并比较死亡患者与痊愈者血糖水平间的差异。结果41例APP患者血糖含量(7.32±2.85)mmol/L,明显高于对照组(4.31±0.50)mmol/L,差异有统计学意义(P<0.01)。其中8例死亡者血糖含量(8.70±3.00)mmol/L亦高于9例痊愈者(7.19±2.79)mmol/L,但差异无统计学意义(P>0.05)。41例APP合并SHG者16例,占39%。结论APP时易合并SHG,其血糖水平的高低与APP患者的预后无关,但可作为反映APP患者应激水平强弱一个有用指标,减弱持续过高的应激反应及降低高血糖,可能对病情的恢复更为有利。
Objective To investigate the value of stress hyperglycemia (SHG) in acute paraquat poisoning (APP), prognosis and treatment. Methods The serum glucose levels of 41 cases of APP patients (9 of them recovered, 8 died and 24 cases improved) were detected by Beckm an CX-3 automatic biochemical analyzer electrode method. 22 cases of outpatients were selected as controls (Excluding all the stress-related factors), and comparing the difference between the blood glucose level of the deceased and the recovered. Results The blood glucose level of 41 patients with APP was (7.32 ± 2.85) mmol / L, which was significantly higher than that of the control group (4.31 ± 0.50) mmol / L, the difference was statistically significant (P <0.01). The blood glucose level in 8 of the 8 death patients (8.70 ± 3.00) mmol / L was also higher than that of 9 patients (7.19 ± 2.79) mmol / L, but the difference was not statistically significant (P> 0.05). 41 cases of APP with SHG in 16 cases, accounting for 39%. Conclusions SHG is easy to be incorporated in APP. The level of blood glucose in APP is not related to the prognosis of APP patients. However, it can be used as a useful index to reflect the stress level in APP patients, which may weaken the sustained high stress response and reduce the hyperglycemia. The recovery is more favorable.