Relationship of serum insulin and peptide C levels with inflammatory reaction in patients with severe multiple trauma / 中华创伤杂志

ABSTRACT

Objective To approach the changes of serum insulin and peptide C and determine their relationship with inflammatory reaction in patients with severe multiple trauma. Methods The serum insulin, peptide C, tumor necrosis factor (TNF)-α, interleukin (IL)-10, C reactive protein (CRP) were detected in 30 patients with severe multiple trauma at days 1,3 and 7 after trauma to analyze the dynamic changes of serum insulin and peptide C and their correlations with Acute Physiology and Chronic Health Evaluation Ⅲ ( APACHE Ⅲ), cytokines and CRP. The changes of cytokines and CRP were also compared with those of serum insulin and peptide C in patients with different outcomes. The changes of serum insulin and peptide C of 35 healthy subjects were detected and used as control. Re-sults The serum insulin and peptide C levels of patients were higher than those in control group at each time point after trauma, with remarkably positive correlation with APACHE Ⅲ. Whether the serum glu-cose and age were controlled or not,serum insulin and peptide C were positively correlated with IL-10 at each time point and with TNF-α and CRP at days 3 and 7. The levels of serum insulin, peptide C and IL-10 were decreased with time in both groups with different outcomes. Meanwhile, the levels of TNF-α and CRP were decreased in the survival groups but increased in the death groups. The levels of above indices in death group were significantly higher than survival groups at the same time point. Conclusions The increasing of serum insulin and peptide C is correlated with inflammatory reaction after severe multiple trauma. The dynamic changes of both indices can either reflect injury severity or be used as an effective index in dynamically monitoring anti-inflammatory degree of the organism.