[Effect of intensive insulin therapy on serum proinflammatory cytokine levels in patients with severe trauma].

OBJECTIVE:To investigate the effect of intensive insulin therapy on serum levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and C reaction protein (CRP), all of which reflected the inflammatory status in patients with severe trauma. METHODS:Forty patients with severe trauma [injury severity score (ISS)>or=20] were randomly divided into intensive insulin therapy group and control group. Enzyme-linked immunoadsorbent assay (ELISA) method was used to determine the TNF-alpha and IL-6 levels within 72 hours after admission. RESULTS:Serum levels of TNF-alpha, IL-6 and CRP in patients received intensive insulin therapy were significantly lower than those in patients without the therapy (P<0.05 or P<0.01). CONCLUSION:Intensive insulin therapy can attenuate the systemic inflammatory response to trauma. The anti-inflammatory actions of insulin, as well as its glycemia controlling effects, might contribute to the improved outcomes of patients with severe trauma.