Effects of intensive insulin therapy on immune factors of obstetrics patients with critical illness

XU Fang; LIU Qiong; QI Hong-bo

Abstract：Objective To investigate the correlation of stress hyperglycemia with serum levels of C reactive protein (CRP), interleukin-6 (IL-6)and Tumor Necrosis Factor-α(TNF-α)in critical obstetrics patients and to explore the effect of IIT on these immune factors. Methods 42 critical obstetrics patients, who were admitted in the ICU of the first affilia-ted hospital of the chongqing medical university between January 2005 and December 2007, were randomly divided into the IIT group (maintenance blood glucose at a level between 4.4 and 6.1mmol/L) and routine therapy group(mainte-nance blood glucose at a level between 10.0 and 11.1mmol/L). Levels of CRP,IL-6 and TNF-α were measured before the treatment and then measured again at 1,3 and 5d after treatment. Results In the routine therapy group, the serum levels of CRP, IL-6 and TNF-α in all cases were significantly increased and were positively correlated with the level of blood glucose. The CRP level of IIT group at 5 d after treatment was (40.92±14. 46)mg/L which was significantly de-creased compared with the level of routine therapy group which was (87.50±30. 20) mg/L(P < 0.05). The IL-6 level of IIT group at 5 d after treatment was (28.76±6.62) ng/L which was significantly decreased compared with the level of routine therapy group which was (47.45±17. 24)ng/L(P < 0.05). The TNF-α level of IIT group began to decrease to (254.37±39.50)ng/L at 1 d after treatment compared with the level of the routine therapy group which was (325.17± 29.47) ng/L(P < 0.05). Then the TNF-α level of IIT group was significantly decreased to (99.71±13.43) ng/L at 5 d after treatment compared with the level of routine therapy group which was(254.73±19. 43)ng/L(P <0.05). Conclu-sion "Intensive insulin therapy" could obviously regulate the inflammatory reaction of post-injury by controlling glyce-mia within the normal level to inhibit excessive inflammatory reaction and have a good prognosis.