Stress hyperglycemia: an essential survival response!
Stress hyperglycemia: an essential survival response!
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DOI：
10.1186/cc12514
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发表时间：
2013-03-06
期刊：
影响因子：
--
通讯作者：
Bellomo R
中科院分区：
文献类型：
--
作者：
Marik PE;Bellomo R
应激性高血糖在危重患者中很常见，似乎是疾病严重程度的标志。此外，入院以及住院期间的平均血糖水平与患者结局密切相关。临床医生、研究人员和政策制定者认为，这种关联与广泛采用的严格院内血糖控制方案和计划有关。然而，对文献的批判性评价表明，在ICU和非ICU患者中严格控制血糖的尝试并不能改善医疗保健结局。我们认为，高血糖症和胰岛素抵抗在急性疾病的设置是一个进化保存的适应性反应，增加主机的生存机会。此外，试图干扰这种极其复杂的多系统自适应反应可能是有害的。本文综述了应激性高血糖和胰岛素抵抗的病理生理机制以及应激性高血糖在急性疾病中的保护作用。
Stress hyperglycemia is common in critically ill patients and appears to be a marker of disease severity. Furthermore, both the admission as well as the mean glucose level during the hospital stay is strongly associated with patient outcomes. Clinicians, researchers and policy makers have assumed this association to be causal with the widespread adoption of protocols and programs for tight in-hospital glycemic control. However, a critical appraisal of the literature has demonstrated that attempts at tight glycemic control in both ICU and non-ICU patients do not improve health care outcomes. We suggest that hyperglycemia and insulin resistance in the setting of acute illness is an evolutionarily preserved adaptive responsive that increases the host's chances of survival. Furthermore, attempts to interfere with this exceedingly complex multi-system adaptive response may be harmful. This paper reviews the pathophysiology of stress hyperglycemia and insulin resistance and the protective role of stress hyperglycemia during acute illness.
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DOI：
10.1111/acem.12015
发表时间：
2012-11
期刊：
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
影响因子：
--
作者：
Green JP;Berger T;Garg N;Horeczko T;Suarez A;Radeos MS;Hagar Y;Panacek EA
通讯作者：
Panacek EA
影响因子：
120.7
作者：
Heyland, DK;MacDonald, S;Drover, JW
通讯作者：
Drover, JW
影响因子：
9.9
作者：
Bruno, A;Levine, SR;Fineberg, SE
通讯作者：
Fineberg, SE
DOI：
10.1590/s0100-879x2006001200012
发表时间：
2006-12-01
影响因子：
2.3
作者：
Barreto, R.E.;Volpato, G.L.
通讯作者：
Volpato, G.L.
影响因子：
3.1
作者：
GAMELLI, RL;LIU, H;HOFMANN, CA
通讯作者：
HOFMANN, CA