Research of CVVH combined withhemoperfusion on insulin resistance in severe patients

doi:10.3969/j.issn.1002-1949.2015.10.011

Abstract：Objective To research influence on hemoperfusion combined with Continuous Vein-Venous Hemofiltration and insulin resistance of severe patients , so as to explore the mechanism of insulin resistance in severe patients .Methods Totally 90 severe patients experienced CRRT in the emergency Intensive Care Unit of our hospital from January 2013 to December 2013 were enrolled into this study.The 90 severe patients were divided into CVVH +HP group(experimental group) and CVVH group(control group ) stochastic and equally.Fasting blood glucose ( FPG), fasting insulin ( FIN) interieukin-1(IL-1),interieukin -6(IL-6),interieukin -8(IL-8) and tumor necrosis factor -alpha(TNF-α) were measured, The ratio of total glucose input and insulin use (G/I) was computed before CRRT and 24 h after CRRT.And glucose amount resistance index ( HOMA-IR) calculated using Homeostasis Model Assessment ( HOMA ) before and after CRRT treatment .Results The levels of FPG,Fin,HOMA-IR, IL-1,IL-6,IL-8 and TNF-αof CVVH+HP group were lower than CVVH group, G/I higher than CVVH group.The difference was significant(P<0.05).IL-1, IL-6, IL-8 and TNF-αare associated with insulin resistance in severe patients .Conclusion Efficacy of CVVH+HP mode about insulin resistance in severe patients is more effective than CVVH group , Its mechanism may be associated with eliminated excessive inflammatory mediators .