同种异体肾移植时血流动力学变化及一氧化氮在其中的作用  

Hemodynamics changes during cadaveric renal transplantation and the effects of NO on RBF

作　　者：马宁[1] 谭红[1] 李树人[1] 

机构地区：[1]首都医科大学附属北京友谊医院麻醉科,北京100050

出　　处：《中国急救医学》2004年第7期475-477,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的　观察肾移植时全身和肾脏血流动力学变化 ,并评价NO在其中的作用。方法　随机选取肾移植手术患者 2 8例 ,分为高血压组 (H组 ,n =14 )和血压正常组 (N组 ,n =14 )。麻醉前、开放前及开放后 5min、30min、1h记录血流动力学指标 ,开放后 5、30min时测量移植肾RBF ;静脉血测定NO、NOS和ET血浆浓度。另抽测 14例无肾脏疾患志愿者血样 ,作为NO、NOS和ET水平的对照值。结果　两组肾移植患者血流动力学变化趋势相近。两组肾移植患者麻醉前NO、NOS及ET均明显高于对照组 (P <0 0 5 ) ,而两组间及组内各时点均没有显著性差异 (P >0 0 5 ) ;对照组和肾移植组中 ,NO、ET与MAP之间分别呈负、正相关 (P <0 0 5 ) ;但肾移植组NO、ET与移植肾RBF相关不明显 (P >0 0 5 )。结论　肾移植时血压正常和偏高时血流动力学相差不大 ;NOObjective To observe the systemic and renal hemodynamics changes during kidney transplantation (KT),and evaluate the effects of NO on it.Methods Twenty-eight patients were randomly divided into 2 groups:group H (hypertension group,n=14)and group N (normal BP group,n=14).Hemodynamics data were recorded before operation,before,5,30 min and 1 h after renal reperfusion,and RBF of transplanted kidney was measured 5 and 30 min after reperfusion;plasma NO,NOS and ET levels were measured at different time points.Blood samples from 14 volunteers (group C) without renal diseases were determined to be the control of NO,NOS and ET plasma levels.Results The hemodynamic data were similar in both group H and N ( P >0 05).NO,NOS and ET plasma levels before anesthesia in both group H and N were all obviously higher than those in group C ( P <0.05),but the differences between and within groups were not significant ( P >0 05);NO and ET were negative and positive correlations with basic MAP values in 3 groups,respectively ( P <0 05);measurement of NO,ET levels did not show any significant correlation with RBF during kidney transplantation operations ( P >0 05).Conclusions During kidney transplantation operations,systemic and renal hemodynamic data were similar in both group H and N;NO-ET may be just one of the factors that regulate it.[

关 键 词：一氧化氮 一氧化氮合酶 内皮素 肾移植 肾缺血/再灌注 血流动力学 肾血流 

分 类 号：R699.2[医药卫生—泌尿科学]