简介：摘要目的探讨重症肺炎与胰岛素抵抗和胰岛β细胞功能损伤的相关性.方法选取２０１２年３月至２０１４年１月在我院就诊的重症肺炎和普通肺炎患者各３０名,选取同期在我院进行健康检查的健康患者３０例作为对照组.重症肺炎和普通肺炎患者分别在入院第２天清晨采集空腹静脉血,测定空腹血糖(FBG),空腹胰岛素(FINS),同时测定TNF－α和超敏C反应蛋白等炎性因子水平.结果重症肺炎组FBG,FINS以及HOMA－IR水平均显著高于普通肺炎组(P＜０．０５)和对照组(P＜０．０５);重症肺炎组HOMA－β显著低于普通肺炎组(P＜０．０５)和对照组(P＜０．０５);重症肺炎组TNF－α水平显著高于普通肺炎组(P＜０．０５)和对照组(P＜０．０５);重症肺炎组Hs－CRP显著高于普通肺炎组(P＜０．０５)和对照组(P＜０．０５).结论重症肺炎患者存在胰岛素抵抗和胰岛β细胞功能损伤,会出现血糖升高,胰岛素水平降低等症状.关键词重症肺炎;胰岛素抵抗;胰岛β细胞功能;相关性AbstractObjectiveToinvestigatetherelationshipbetweenseverepneumoniaandinsulinresistanceandthefunctionofpancreaticisletbetacells．Methods３０patientswithseverepneumoniaand３０patientswithpneumoniainourhospitalfromMarch２０１２toJanuary２０１４wereselected,and３０casesofhealthypatientsinourhospitalwereselectedasthecontrolgroup．Fastingvenousbloodwascollectedfrompatientswithseverepneumoniaandcommonpneumoniaintheearlyseconddaysafteradmission,fastingbloodglucose(FBG),fastinginsulin(FINS),andTNF－andCweredetermined．ResultsThelevelsofHOMA－IR,FINSandFBGinseverepneumoniagroupweresignificantlyhigherthanthatinnormalgroup(P＜０．０５)andcontrolgroup(P＜０．０５);HOMA－βinseverepneumoniagroupwassignificantlylowerthanthatincontrolgroup(P＜０．０５)．ThelevelsofTNF－inseverepneumoniagroupweresignificantlyhigherthanthoseinnormalgroup(P＜０．０５)andcontrolgroup(P＜０．０５);Hs－CRPinseverepneumoniagroupwassignificantlyhigherthanthatinnormalgroup(P＜０．０５)andcontrolgroup(P＜０．０５)．ConclusionInsulinresistanceandbetacellfunctiondamageinpatientswithseverepneumonia,thebloodglucoselevels,insulinlevelsdecreasedandothersymptoms．Keywordsseverepneumonia;insulinresistance;pancreaticbetacellfunction;correlation中图分类号R５８７文献标识码B文章编号１００８－６３１５(２０１５)１２－０８５９－０２