摘要
目的研究小剂量硝酸甘油对合并高血压并行腹腔镜妇科手术的患者氧化应激及apelin-12水平的影响。方法选取腹腔镜下行全子宫切除术的高血压患者80例,采用随机数表法分为硝酸甘油组和对照组。硝酸甘油组在气腹开始至手术结束泵注小剂量硝酸甘油[0.10~0.25μg/(kg·min)],对照组泵注等量生理盐水。于术前(T0),气腹开始30 min(T1)及手术结束后1 h(T2)抽取外周肘静脉血,比较2组患者血清血管紧张素-Ⅱ(Ang-Ⅱ)、IL-6及apelin-12水平变化和ST-T改变。结果组内相比,随着气腹时间的增加,血清Ang-Ⅱ、IL-6水平逐渐升高,apelin-12水平逐渐降低;同对照组相比,硝酸甘油组T1、T2时间点的血清Ang-Ⅱ和IL-6水平上升幅度明显降低,apelin-12水平下降幅度也明显降低,差异均有统计学意义(P均<0.05)。2组ST-T异常发生率比较差异无统计学意义(P>0.05)。结论小剂量硝酸甘油可以缓解腹腔镜下行子宫全切术合并高血压患者的应激反应,apelin-12可能协同一氧化氮延缓氧化应激的发生发展。
Objective To evaluate the effect of low-dose nitroglycerin on oxidative stress and apelin-12 levels in hypertension patients undergoing laparoscopic gynecological surgery.Methods Eighty patients with hypertension who underwent laparoscopic total hysterectomy were recruited and divided into the nitroglycerin group and control group by random number table method.From the beginning of pneumoperitoneum to the end of operation,patients in the nitroglycerin group were pumped with nitroglycerin(0.10-0.25μg/(kg·min)),and those in the control group were pumped with the same amount of normal saline.Peripheral elbow venous blood was drawn before operation(T0),30 min after pneumoperitoneum(T1),and 1 h after operation(T2).The changes of serum levels of Ang-Ⅱ,IL-6,apelin-12,and ST-T were compared between two groups.Results With the increase of pneumoperitoneum time,the serum levels of Ang-Ⅱand IL-6 were gradually elevated,whereas the serum levels of apelin-12 were steadily decreased within each group.Compared with the control group,the increase of serum levels of Ang-Ⅱand IL-6 at T1 and T2 were significantly decreased and the decrease of serum level of apelin-12 was also significantly decreased in the nitroglycerin group(all P<0.05).The incidence of ST-T abnormality had no statistical significance between two groups(P>0.05).Conclusions Low-dose nitroglycerin can alleviate the stress response of patients with hypertension undergoing laparoscopic hysterectomy.Apelin-12 may coordinate with NO to delay the incidence and development of oxidative stress.
作者
吴丹
杨闪
丁毅
范俊柏
Wu Dan;Yang Shan;Ding Yi;Fan Junbai(School of Anesthesiology,Shanxi Medical University,Taiyuan 030001,China)
出处
《新医学》
CAS
2022年第2期118-122,共5页
Journal of New Medicine
基金
山西省自然科学基金(201701D121139)。
