1、 研究背景Van den Berghe 范围： SICU方案：前瞻、随机、对照研究 病例数：1548目标血糖： 80110 mg/dl结果：住院死亡率下降 34%急性肾功能衰竭下降 41%输血量下降 50% N. Engl. J. Med., Nov 2001; 345: 1359 1367. 范围：内科 ICU病例数：1200 结果：1、强化治疗组与常规治疗组对医院内的病死率并无差异2、在预防ARF，减少 MV时间，缩短 ICU滞留和住院时间有显著差异结论：内科 ICU中，强化胰岛素治疗显著降低危重病人的发病率，而不是 病死率N. Engl. J. Med., Feb 2006; 354:
2、449 - 461. Krinsley J范围： SICU时间： 2003-4 2004-1病例数：800目的：评估强化胰岛素治疗方案的效果设计：强化组 : BG140mg/dl常规组：BG200mg/dl结果： ARF减少 75% ;PRB 输 减少 18 7% ;住院死亡率下降2 3% ;ICU时间缩短 10 8%Mayo Clin Proc, Aug 2004; 79(8): 992-1000.Furnary病例数：2 33病 ：CABG目的：评估死亡率与 3 血糖 性结果： Endocr Pract, Mar 2004; 10 Suppl 2: 21-33.Furnary持续胰岛素输注
3、减少糖尿病患者心脏外科手术伤口感染率治疗 组 强化胰岛素输 方案n 14 下 胰岛素输 方案n 14 In l n d e血糖mg/dl mm l/ 目标 ：150200mg/dl 8 311 1 85% 标血糖1 1 4血糖17 0 8血糖181 1 2血糖17 1 5 47% 标血糖241 1 血糖20 1 2血糖1 5 1 3血糖188 1 4 治疗的 currency1时间 3 血糖“ fifl 率 0 8 减少2 5 12/14 1 % 1 / 8 Furnary降低 SIS 的” ，而 372 的糖病人降低死亡率57危重病人中发ARF下降75%CICU内的 糖病人的院内 下降End
4、ocr Pract, Mar 2004; 10 Suppl 2: 21-33.Krinsley J Perioperative glucose control.J KrinsleyCurr Opin Anaesthesiol, Apr 2006; 19(2): 111-6. Effect of an intensive glucose management protocol on the mortality of critically ill adult patients.JS KrinsleyMayo Clin Proc, Aug 2004; 79(8): 992-1000. Furnary
5、 Continuous insulin infusion reduces mortality in patients with diabetes undergoing coronary artery bypass graftingAnthony P. Furnary, Guangqiang Gao, Gary L. Grunkemeier, YingXing Wu, Kathryn J. Zerr, Stephen O. Bookin, H. Storm Floten, and Albert StarrJ. Thorac. Cardiovasc. Surg., May 2003; 125: 1
6、007. Continuous intravenous insulin infusion reduces the incidence of deep sternal wound infection in diabetic patients after cardiac surgical proceduresAnthony P. Furnary, Kathryn J. Zerr, Gary L. Grunkemeier, and Albert StarrAnn. Thorac. Surg., Feb 1999; 67: 352 - 360. Effect of hyperglycemia and
7、continuous intravenous insulin infusions on outcomes of cardiac surgical procedures: the Portland Diabetic Project.AP Furnary, Y Wu, and SO BookinEndocr Pract, Mar 2004; 10 Suppl 2: 21-33. 回顾性分析 500mg/dl 17.4% 300mg/dl 52.5% 150mg/dl 30.1%BG MA 与死亡率 性 3 BG与死亡率 性 500mg/dl 3.5% 300mg/dl 38.3% 150mg/dl 58.2%与3 BG 性 194岁ThemeGallery is a Design Digital Content & Contents mall developed by Guild Design Inc.1940岁 16724mg/dl 41岁 18235mg/dl0 3岁 14421mg/dl412岁 16032mg/dl1318岁 15241mg/dl
