[1]孙炜,朱高红,卫江亮,等.老年患者胆囊切除术围手术期血浆内皮素和降钙素基因相关肽水平分析[J].国际放射医学核医学杂志,2011,35(2):104-107.[doi:10.3760/cma.j.issn.1673-4114.2011.02.009]
　SUN Wei,ZHU Gao-hong,WEI Jiang-liang,et al.Analysis of plasma edothelin and calcitonin gene-related peptide in aged patients undergoing laparoscopic cholecystectomy[J].International Journal of Radiation Medicine and Nuclear Medicine,2011,35(2):104-107.[doi:10.3760/cma.j.issn.1673-4114.2011.02.009]
点击复制

老年患者胆囊切除术围手术期血浆内皮素和降钙素基因相关肽水平分析(/HTML)
分享到：

《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
35
期数:
2011年第2期
页码:
104-107
栏目:
临床核医学
出版日期:
1900-01-01

文章信息/Info

Title:
Analysis of plasma edothelin and calcitonin gene-related peptide in aged patients undergoing laparoscopic cholecystectomy
作者:
孙炜;  朱高红;  卫江亮;  胡建伟
650032 昆明, 昆明医学院第一附属医院核医学科
Author(s):
SUN Wei;  ZHU Gao-hong;  WEI Jiang-liang;  HU Jian-wei
Department of Nuclear Medicine, the First Affiliated Hospital of Kunming Medical College, Kunming 650032, China
关键词:
胆囊切除术; 老年人; 麻醉; 降钙素基因相关肽; 内皮缩血管肽类
Keywords:
Cholecystectomy; Aged; Anaesthesia; Calcitonin gene-related peptide; Endothelins
DOI:
10.3760/cma.j.issn.1673-4114.2011.02.009
摘要:
目的 观察老年患者胆囊切除术围手术期血浆内皮素和降钙素基因相关肽(CGRP)水平的变化,了解内皮素和CGRP在老年患者手术麻醉应激反应中的作用。方法 选取择期行胆囊切除术的患者60例,根据年龄分为实验组和对照组,其中,实验组年龄>65岁,平均年龄(44±17)岁;对照组年龄<65岁,平均年龄(7l±5)岁,两组病例数均为30例。分别于手术麻醉前(T0期)、气管插管后(T1期)、胆囊切除时(T2期)、术毕(T3期)、术后24h(T4期)抽取静脉血,采用放射免疫分析法测定血浆中内皮素和CGRP水平。结果 T0期实验组血浆中内皮素水平高于对照组,但两组间比较差异无统计学意义(t=0.971,P>0.05);T1期两组患者血浆中内皮素水平均逐渐升高,其中实验组增高明显(t=4.258,P<0.05);T2期两组患者血浆中内皮素水平继续升高,实验组增高明显(t=5.134,P<0.01);T3期对照组患者血浆内皮素水平开始降低,而实验组患者内皮素水平继续升高(t=6.627,P<0.01);T4期两组患者内皮素水平均恢复到T0期水平,两组间比较差异无统计学意义(t=1.917,P>0.05)。对照组患者血浆CGRP水平在围手术期变化不明显,而实验组患者血浆中CGRP水平在T0期后降低,T2期又逐渐增高,到T3期达到最高。两组患者在T1期和T3期的CGRP水平相比,差异有统计学意义(t=4.084和t=4.085,P均<0.05)。结论 老年患者胆囊切除术围手术期内皮素和CGRP水平变化均较青壮年患者显著,内皮素的变化尤为明显,围手术期危险更大。
Abstract:
Objective To investigate the effects of laparoscopic cholecystectomy on the plasma levels of endothelin and calcitonin gene-related peptide (CGRP)in elderly patients. Methods Sixty patients undergoing elective laoaroscopic cholecystectomy were divided into <65 years old group and >65 years old group according to their ages (30 cases in each group). The plasma levels of endothelin and CGRP were measured before surgery, after intubation, at the time of gallbladder removal, immediately after surgery and 24 hours after surgery by radioimmunoassay. Results There was no significant difference in endothelin levels between the two groups before the surgery (t=0.971, P>0.05). The endothelin levels in both groups gradually increased after the intubation, but more significantly in the >65 years old group (t=4.258, P<0.05). The increased endothelin levels were maintained during the surgery in both groups, but they were higher in the >65years old group (t=5.134,P<0.01). When the surgery was completed, the level of endothelin in the >65 years old group continued to increase, but it decreased in the <65 years old group, and there was significantly difference between the two groups(t=6.627, P<0.01). Endothelin levels in both groups at 24 hours after the surgery returned to the levels before surgery, and there was no significant difference between the two groups (t=1.917, P>0.05). The CGRP levels had not significantly changed during the perioperative period in the <65 years old group. In the >65 years old group, CGRP levels decreased after anaesthesia, but increased during the surgery, and then reached the highest level at the time of the surgery completed. CGRP levels were significant difference between the two groups after intubation and immediately after surgery (t=4.084 and t=4.085, P<0.05). Conclusion The levels of endothelin and CGRP had significantly changed elderly patients than those in young patients, especially for endothelin.

参考文献/References:

[1] 谭敦勇,张继峰,牛大地,等.降钙素基因相关肽拮抗内皮素生物效应的研究.中国病理生理杂志,1993,9(5):653-657.
[2] 庄心良,曾因明,陈伯銮.现代麻醉学.3版.北京:人民卫生出版社,2004:1441-1446.
[3] Nelson JB, Opgenorth TJ, Fleisher LA, et al. Perioperative plasma endothelin-1 and Big endothelin-1 concentrations in elderly patients undergoing major surgical procedures. Anesth Analg, 1999,88(4):898-903.
[4] 沈通桃.麻醉和手术对内皮素分泌的影响.国外医学麻醉与复苏分册,2001,22(5):269-271.
[5] 匡洪宇,邹伟,葛茂振,等.实验性脑出血大鼠急性期血浆内皮素和降钙素基因相关肽含量变化的研究.中国危重病急救医学,1999,11(10):627-629.
[6] Moreau P, d’Uscio LV, Shaw S, et al. Angiotensin II increases tissue endothelin and induces vascular hypertrophy:reversal by ET(A)-receptor antagonist. Circulation, 1997, 96(5):1593-1597.

相似文献/References:

[1]孟钺.68例老年肺结核X线及CT征象分析[J].国际放射医学核医学杂志,2010,34(1):58.[doi:10.3760/cma.j.issn.1673-4114.2010.01.016]
[2]郭树龙,张久君.相对低剂量甲泼尼龙联合99Tc-MDP治疗老年Graves眼病的疗效观察[J].国际放射医学核医学杂志,2009,33(5):287.[doi:10.3760/cnla.j.issn.1673-4114.2009.05.010]
　GUO Shu-long,ZHA NG Jiu-jun.Efficacy of combined 99Tc-methylenediphosphonate and lower-dose meth ylprednisolone in the treatment of old patients with moderate-to-severe Graves ophthalmopathy[J].International Journal of Radiation Medicine and Nuclear Medicine,2009,33(2):287.[doi:10.3760/cnla.j.issn.1673-4114.2009.05.010]
[3]鲁杰,刘强.老年鼻咽癌115例放疗疗效评价[J].国际放射医学核医学杂志,2008,32(4):254.
[4]张文学,姜炜,吕仲虹,等.常规放疗结合后程立体定向放射治疗老年非小细胞肺癌患者的预后分析[J].国际放射医学核医学杂志,2007,31(2):125.
　ZHANG Wen-xue,JIANG Wei,LV Zhong-hong,et al.Prognostics analysis of common radiotherapy combined stereotactic radiotherapy for non-small cell lung cancer of old patients[J].International Journal of Radiation Medicine and Nuclear Medicine,2007,31(2):125.

备注/Memo

备注/Memo:
收稿日期:2010-12-06。
通讯作者:孙炜,Email:1790083846@qq.com
更新日期/Last Update: 1900-01-01