摘要
目的探讨血管紧张素转换酶(ACE)基因多态性对高血压患者气管插管心血管反应的影响。方法采用限制性片段长度多态性聚合酶链反应法测定120例高血压患者ACE基因型,并据此分为三组:A组40例为DD/DI型;B组40例为II型;C组40例为DD/DI型,麻醉诱导前鼻腔滴入卡托普利混悬液25mg。记录麻醉诱导前、后和插管后即刻、1.5min和5min的SBP、DBP、HR和ECG,计算心率-收缩压乘积(RPP)。结果与诱导前比较,A、B组气管插管后即刻、1.5min和5min的SBP和RPP升高,HR增快(P<0.05或P<0.01),而C组的SBP和RPP升高不明显(P>0.05)。插管后即刻、1.5min和5min时,A组SBP、RPP和HR均大于B、C组(P<0.05或P<0.01)。A组ECG异常的发生率高于B、C组(32.5%vs.12.5%、0)(P<0.05)。结论 DD/DI基因型高血压患者气管插管时心血管反应明显;麻醉诱导前鼻腔滴入卡托普利对此有预防作用。
Objective To investigate the effects of angiotension converting enzyme（ACE）gene polymorphism on cardiovascular response to endotracheal intubation in the patients with essential hypertension（EH）.Methods ACE genotypes were detected by RFLP-PCR in 120 patients with EH,who were divided into three groups of A（with genotype DD/DI）,B（with genotype II）and C（with genotype DD/DI and treated with captopril 25 mg nasally dropped at 5 minutes before induction）with 40 cases each.The SBP,DBP,HR and ECG were recorded before and after induction at 0,1.5 and 5 minutes after intubation.The product of HR and SBP（RPP）was calculated as well.Results Compared to before,the SBP,HR and RPP in groups of A and B were increased（P〈0.05 or P〈0.01）,but the increases of SBP and RPP in group C were not significant（P〉0.05）.The SBP,HR and RPP were higher in group A than those in groups of B and C at 0,1.5 and 5 minutes after intubation（P〈0.05 or P〈0.01）.The incidence of abnormalities on ECG was higher in group A than that in groups of B and C（32.5% vs.12.5% and 0）（P〈0.05）.Conclusion EH patients with genotype DD/DI show significant hemodynamic fluctuation during endotracheal intubation,which can be prevented by captopril administration before anesthesia induction.
出处
《江苏医药》
CAS
2016年第2期186-188,共3页
Jiangsu Medical Journal
关键词
高血压
血管紧张素转换酶基因多态性
气管插管心血管反应
Essential hypertention
Angiotensin converting enzyme gene polymorphism
Cardiovascular response to endotracheal intubation
