tailieunhanh - Báo cáo y học: "Is insulin an endogenous cardioprotector"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Is insulin an endogenous cardioprotector? | Available online http content 6 5 389 Commentary Is insulin an endogenous cardioprotector Undurti N Das Chairman and Research Director EFA Sciences LLC Norwood Massachusetts USA Correspondence Undurti N Das undurti@ Published online 31 July 2002 Critical Care 2002 6 389-393 This article is online at http content 6 5 389 2002 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Stress hyperglycemia and diabetes mellitus with myocardial infarction are associated with increased risk for in-hospital mortality congestive heart failure or cardiogenic shock. Hyperglycemia triggers free radical generation and suppresses endothelial nitric oxide generation and thus initiates and perpetuates inflammation. Conversely insulin suppresses production of tumor necrosis factor-a and free radicals enhances endothelial nitric oxide generation and improves myocardial function. It is proposed that the balance between insulin and plasma glucose levels is critical to recovery and or complications that occur following acute myocardial infarction and in the critically ill. Adequate attention should be given to maintaining euglycemia plasma glucose 110 mg dl in order to reduce infarct size and improve cardiac function while using a glucose-insulin-potassium cocktail. Keywords cardiac failure eardioproteetion diabetes free radicals glucose hyperglycemia insulin nitric oxide tumor necrosis factor septicemia septic shock Patients with acute myocardial infarction AMI exhibit raised blood glucose concentrations 1-3 . In addition a positive association between hyperglycemia and mortality from AMI has been reported 4 although the exact reason for this association is not clear. Intensive treatment with insulin to lower plasma glucose concentrations decreases overall mortality in patients with diabetes mellitus who have AMI. In a prospective randomized controlled study involving adults admitted to surgical intensive care units and receiving .