摘要
目的 :探讨术前口服卡托普利对腹主动脉修复患者主动脉阻断及再通后血压的影响及机制。方法 :2 5例肾下主动脉瘤患者 ,随机分为对照组 (A组n =10 )和治疗组 (B组n =15) ,B组患者术前 3 0min口服卡托普利 15mg。记录主动脉阻断前后 5min、 2 0min及主动脉再通后 10min动脉压 (MAP)、中心静脉压 (CVP)变化 ,测定主动脉阻断前、后及再通后血浆血管紧张素 -Ⅱ (AT -Ⅱ )及内皮素 -Ⅰ (ET -Ⅰ )的浓度。结果 :A组主动脉阻断后MAP均明显高于阻断前 (P <0 0 1或P <0 0 5) ,其再通后的MAP则明显低于阻断前 ,(P <0 0 5)。B组主动脉阻断前后及再通后MAP变化不明显 ,与A组比较 ,B组阻断后 5minMAP明显降低 (P <0 0 5) ,再通后MAP则明显升高 (P <0 0 5)。A组阻断后CAP较阻断前明显升高 (P <0 0 5或P <0 0 1) ,B组变化不明显。A组阻断后及再通后AT -Ⅱ、ET -Ⅰ均显著升高 ,B组两种激素也有升高但幅度明显低于A组。结论 :在主动脉修复手术中 ,术前服用卡托普利能部分缓解患者主动脉阻断后的高血压及再通后的低血压反应 ,这可能与卡托普利对术中血管紧张素 -Ⅱ和内皮素 -Ⅰ的影响有关。
Objective:To evaluate the effects of captopril take n be fore operation on blood pressure in patients with infrarenal aortic aneurysm dur ing operation.Methods:Twenty-five patients with infrarenal aorti c aneurysm were randomly divided into two groups:control group(group A,n=10)and c aptopril group(group B,n=15).In Group B,captopril(15mg per patient)was orally ad ministrated 30 minutes before operation.Radial arterial pressure(MAP)and centra l venous pressure(CVP)were recorded before aortic clamping,5minutes and 10 minute s after clamping,and 10 minutes after declamping,respectively.The angiotensin-Ⅱ (AT-Ⅱ)and endothelins-L(ET-Ⅰ)content in plasma were assayed before clamping,af t er clamping and after declamping.Results:In group A,MAP increas ed significantly after clamping(P<0 01 or P<0 05)and decreased significantly a fter declamping(P<0 05).However,there were no remarkable changes durin g operat ion in group B.Compared with group A,MAP 5 minutes after clamping in group B was significantly lower (P<0 05)and it obviously increased 10 minutes after decla mping(P<0 05).CVP in group A increased significantly after clamping and no rem arkable changes of CVP were observed in group B.In group A,AT-Ⅱand ET-Ⅰalso in c reased in group B after clamping and declamping,While they were lower than that in group A.Conclusion:Taking captopril before operation can alle viate hypertension response after aortic clamping and hypotension after declampi ng,which might be related to its decreasing the release of AT-Ⅱ and ET-Ⅰ
出处
《西南国防医药》
CAS
2004年第1期23-26,共4页
Medical Journal of National Defending Forces in Southwest China
