摘要
目的 探讨急性等容性血液稀释 (ANH)对血浆内皮素 (ET)和降钙基因相关肽(CGRP)水平的影响。方法 选择非心脏手术ASAⅠ～Ⅱ级患者 2 0例 ,麻醉前快速输入复方乳酸钠1 0～ 1 5ml/kg。麻醉后从桡动脉放血 1 0ml/kg ,同时经静脉输入等量的 4 %琥珀酰明胶。观察ANH麻醉前 (T0 )、血液稀释完成后 1 0min(T1 )、2 0min(T2 )、30min(T3 )的血液动力学、血浆ET和CGRP浓度的变化。结果 ANH前后MAP、HR、SpO2 和ECG均较稳定。ANH后 1 0min、2 0min血浆ET水平分别为 (1 4 4 4 7± 1 9 1 7) pg/ml和 (1 5 7 1 7± 1 2 4 5 ) pg/ml,但明显高于ANH前的 (1 2 7 6 8±2 0 92 ) pg/ml(P <0 0 5 )。ANH后 1 0min、2 0min血浆CGRP水平分别为 (5 4 72± 2 5 6 5 )pg/ml和(5 5 32± 1 7 94 )pg/ml,也明显高于ANH前的 (4 4 6 2± 1 6 90 ) pg/ml(P <0 0 5 )。而ET/CGRP比值无明显变化。结论 ANH近期血浆ET和CGRP水平均有一定的增加 ,但ET/CGRP比值的变化无统计学意义 ,同时心血管反应不明显 。
Objective To investigate the effects of moderate acute normovolemic hemodilution (ANH) on plasma levels of endothelin(ET) and calcitonin gene related peptide (CGRP). Methods Twenty patients (ASA gradeⅠ Ⅱ) undergoing selective non cardiac surgery were enrolled in this study. Before anesthesthsia,lactated Ringers solution 10 15 ml ml/kg was insfused. After induction of anesthesthsia,ANH was carried out by bleeding 10 ml/kg and the same volume of gelofusine infusion at the same time. Hemodynamics and plasma level of ET and CGRP were measured before ANH (T 0) and at 10 min(T 1),20 min(T 2) and 30 min(T 3) after ANH. Results After ANH,MAP,SpO 2 and ECG remained stable at the normal levels. The levels of ET at 10 min and 20 min after ANH were (144 47±19 17) pg/ml and (157 17±12 45) pg/ml,which were significantly higher than that before ANH〔(127 68±20 92) pg/ml, P< 0 05〕.The levels of CGRP at 10 min and 20 min after ANH were (54 72±25 65) pg/ml and (55 32±17 94) pg/ml,which were higher than that before ANH 〔(44 62±16 90) pg/ml, P< 0 05〕.The ratio of ET/CGRP was not changed significantly. Conclusion Plasma ET and CGRP increase during early stage of ANH with the ratio of ET/CGRP being stable,indicating that the ratio of ET/CGRP plays takes an important role in maintaining cardiovascular stability.
出处
《临床麻醉学杂志》
CAS
CSCD
2003年第10期591-593,共3页
Journal of Clinical Anesthesiology
