摘要
背景2010年以来有关剖宫产术中自体血回输相关急性低血压（acutehypotensioncorrelatingwithautologousbloodtransfusion，AHABT）案例报道渐增，日益引起麻醉医师的关注。目的阐述剖宫产术中AHABT发生的可能机制。内容在自体血回输（autologousbloodtransfusion，ABT）过程中，AHABT可能与几种主要调节血压物质的水平变动有关。首先，缓激肽，一种血管活性肽，当血管紧张素转换酶（angiotensinconvertingenzyme，ACE）即缓激肽降解酶水平较低时，可在一些患者体内蓄积。ABT过程可激活缓激肽生物活性，导致血管扩张。其次，自体血经过白细胞过滤器过滤后，血液中IL-6、补体3水平可能会升高，进而使平均动脉压降低。趋向控制血管活性物质水平是否可预防AHABT尚需进一步研究去阐明。
Background Since 2010, series of cases about acute hypotension related to autologous blood transtusion （AHABT） in cesarean section have been reported, drawing attention from the anesthesiologists Objective To reveal the possible mechanisms underlying AHABT in cesarean section. Content AHABT may be associated with alterations in several molecules importantly regulating blood pressure during autologous blood transfusion （ABT）. First, bradykinin, a vasoactive peptide, accumulates in some patients having lower levels of its degrading enzyme, angiotensin converting enzyme （ACE）. ABT triggers its bioactivity, leading to vasodilation. Second, white blood cell filtering is an essential procedure in ABT, and it increases levels of IL-6 and complement 3 in the blood, which may contribute to reduced mean artery pressure. Trend Further investigations are warranted to address whether controlling the levels of vasoactive molecules would prevent AHABT.
出处
《国际麻醉学与复苏杂志》
CAS
2017年第7期634-636,650,共4页
International Journal of Anesthesiology and Resuscitation
关键词
剖宫产术
自体血回输
低血压
Cesarean section
Autologous blood transfusion
Hypotension
