关键词: 脓毒症, 强化胰岛素治疗, 血管性假血友病因子, 内皮素1, 一氧化氮

Abstract: AIM: To investigate the effects of intensive insulin therapy on the prognosis and serum vWF,ET-1,NO levels in patients with sepsis.METHODS: Ninety patients were randomly assigned to intensive insulin therapy group and conventional insulin therapy group, serum von Willebrand factor (vWF), endothelin-1 (ET-1) and nitric oxide (NO) of the two groups of patients were determined by enzyme-linked immunoadsorbent assay double antibody sandwich principle (ELISA) before treatment and the next 3 d,7 d after treatment. At the same time we observed the two groups of patients with the days of hospitalized in ICU, number of days for using mechanical ventilation , the last day of APACHE II score in ICU and incidence rate of hypoglycemia and 28 d mortality.RESULTS: Compared with conventional insulin therapy group, vWF, TM and ET-1 levels in intensive insulin therapy group were significantly decreased (P<0.05),NO were significantly higher (P<0.05);and the days of hospitalized in ICU, number of day for using mechanical ventilation, the last day of APACHE II score in ICU, 28-d mortality were significantly decreased (P <0.05)in intensive insulin therapy group, and incidence rate of hypoglycemia of two group had no difference(P>0.05).CONCLUSION: Intensive insulin therapy in patients with sepsis can reduce serum vWF, ET-1 levels and elevate NO levels,at the same time can reduce the case-fatality rate of patients,improve the prognosis.

Key words: Sepsis, Intensive insulin therapy, von Willebrand factor, Endothelin-1, Nitric oxide