术后镇痛对冠心病患者肾素-血管紧张素-醛固酮系统的影响  

Effect of postoperative analgesia on rennin-angiotensin-aldosterone system in patients with coronary artery disease

作　　者：李海中[1] 高改云[2] 杨军[3] 

机构地区：[1]南阳医学高等专科学校附属医院麻醉科,河南省南阳473058 [2]河南省南阳市中心医院干部病房 [3]南阳医学高等专科学校附属医院胸外科,河南省南阳473058

出　　处：《中国基层医药》2006年第1期38-39,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的比较胸段硬膜外阻滞(TEA)镇痛与静脉镇痛(GA)对冠心病患者术后肾素-血管紧张素-醛固酮系统(R-A-A-S)的影响。方法60例择期行胸部、上腹部手术的冠心病患者,随机分为TEA组和GA组。分别于术前1d、术毕清醒后1h和术后第1天同一时间点抽取静脉血测定血浆肾素活性(PRA)、血管紧张素Ⅱ(AⅡ)及醛固酮(ALD)的浓度,采用视觉模拟评分法评定镇痛效果。结果镇痛评分无明显差异。术后PRA、AⅡ及ALD值与术前比较TEA组差异无显著意义(P>0.05)。GA组明显升高(P<0.05),组间比较差异有显著意义(P<0.05)。结论TEA镇痛不会对冠心病患者术后R-A-A-S产生不良影响,能有效地防止和治疗围术期心肌缺血和心肌梗死。Objective To investigale the effect of thoracic epidural anethesia analgesia（TEA） and general anesthesia analgesia （GA） on rennin-angiotensin-aldosterone system （R-A-A-S） in postoperative analgesia patients with coronary artery disease. Methods Sixty patients with coronary artery disease undergoing thoracic or upper abdomen surgery were randomly divided into two groupa：group of TEA（ n = 30） and group of GA（ n = 30）. Both were collected in the day before operation and hour and a clay after operation plasma rennin aetivity（PRA） ,angiotensin Ⅱ （AⅡ ）,and aldosterone（ALD） were measured by radio immunoassary. Results There were no significant difference between pre-operation and after-operation in TEA group（P 〉 0.05）. There were significant difference between preoperation and after-operation in GA group（P 〈 0.05）. There were significant difference between the two groups（ P 〈 0.05）. Conclusion TEA can inhibit the steess responses and has no adverse effects on R-A-A-S in postoperative. It can protect from myocardial ischemia and myocardial infarction around operation.

关 键 词：冠状动脉心脏病 麻醉 术后镇痛 冠心病 肾素-血管紧张素-醛固酮系统 

分 类 号：R614[医药卫生—麻醉学]