The Correlation Between Glucose Metabolism And Inflammatory Immune Response In Severe Burn Patients

Objective:Previous clinical work and research on the relationship between stress hyperglycemia and inflammatory response,immune cells about burn patients have not received enough attention.Now more and more evidence shows that posttraumatic fluctuating glucose metabolism is significantly correlated with immune cells and their mediated inflammatory responses,as well as the progression of inflammation itself.The main goal of the research is to provide evidence for the relationship between blood glucose and inflammation in patients with severe burns,and to provide a basis for the stable control of blood glucose and inflammatory indicators in patients with severe burns after clinical treatment.Methods:According to the inclusion criteria,56 patients with severe burns were selected from the Second Affiliated Hospital of Kunming Medical University from June 2017 to May 2019.Patients were divided into two groups according to their blood glucose level:normal blood glucose group and elevated blood glucose group,among them,32 people in the normal blood glucose group(group A)(FPG<7.0mmol/L)and 24 people in the elevated blood glucose group(group B)(FPG 7.0mmol/L).BAfter collecting the patient's indicators in Burn shock stage,Burn resorption period,Burn preoperative period,Burn postoperative period,including Neutrophil,Lymphocytes,Neutrophil proportion,Lymphocyte proportion,hs-CRP and Interleukin-6(IL-6).A retrospective study was conducted on the correlation of selected index levels after burns.Result:There was no significant statistical difference between the two groups except the postoperative Lymphocyte count.the Fasting blood glucose,the Calcitonin the hs-CRP,the IL-6,the Neutrophil count,the Neutrophil ratio,the Lymphocyte ratio at different time there were significant statistical differences(p/Z<0.05).The correlation between each laboratory index and Fasting blood glucose was analyzed in the normal blood glucose group,FPG and CRP were highly correlated at different time points(r>0.80,p<0.05),There was a significant to high correlation between FPG and Lymphocyte ratio in Burn resorption period,Burn preoperative period,Burn postoperative period(r>0.50,p<0.05).FPG also showed a significant correlation with PCT in Postoperative period(r>0.50,p<0.05).In the analysis of the correlation between each laboratory index and Fasting blood glucose in the elevated blood glucose group,FPG and CRP showed a high correlation at each time point(r>0.80,p<0.05),there was a significant to high correlation between FPG and Neutrophil ratio(r>0.50,p<0.05),FPG was highly correlated with lymphocyte ratio in burn shock stage,preoperative period,postoperative period(r>0.80,p<0.05),FPG was significantly correlated with lymphocyte count in Burn shock stage,Burn resorption period(r>0.50,p<0.05),FPG was highly correlated with i1-6 in Burn resorption period(r>0.50,p<0.05),and FPG was significantly correlated with PCT after surgery(r>0.50,p<0.05).Conclusion:Severe burn patients without strict blood glucose management,There was a high correlation between Fasting blood glucose and the Lymphocyte ratio,hs-CRP in most stages in both groups.In addition,the hyperglycemia group showed a significant correlation between blood glucose and Neutrophil ratio,Lymphocyte count,IL-6 in some stages.In the hyperglycemia group,all inflammatory indicators were significantly increased under the stress hyperglycemia state.The hyperglycemia state would promote the occurrence and development of inflammation and influence the level and proportion of immune cells to a certain extent.As a result,the average length of stay was extended.