高血压患者多巴胺受体D_1-A/G基因型与全麻围拔管期心血管反应的关系  

Relationship between dopamine D_1 receptor-48A/G genotypes and hemodynamic response to extubation in patients with essential hypertension

作　　者：王军[1] 胡毅平[1] 孙含哲[1] 李筱[1] 穆会君[2] 

机构地区：[1]无锡市人民医院麻醉科,214023 [2]无锡市人民医院中心实验室,214023

出　　处：《江苏医药》2011年第5期570-572,共3页Jiangsu Medical Journal

摘　　要：目的探讨原发性高血压患者多巴胺受体D1-48A/G基因型与全麻围拔管期心血管反应的关系。方法有EH病史的腹部手术患者120例,用RFLP-PCR法测定多巴胺受体D1-48A/G基因型。按基因型均分为A、C组（均为AG＋GG型）和B组（AA型）。三组均以相同麻醉药诱导及维持。C组拔管前5 min泵注硝酸甘油1~1.5μg.kg-1.min-1控制性降压。于术毕、拔管后0、1.5、5、15 min记录收缩压（SBP）、舒张压（DBP）、心率（HR）和ECG。结果拔管后0、1.5、5和15 min,SBP、DBP、HR,A、B组均明显高于术毕（P〈0.01或P〈0.05）。拔管后0、1.5、5和15 min,A组SBP明显高于C组,DBP明显高于B、C组（P〈0.01）。A组围拔管期心律失常明显多于B、C组（P〈0.05）。结论 AG型高血压患者围拔管期血液动力学变化明显,硝酸甘油对此有一定防治效果。Objective To investigate the relationship between different dopamine D1 receptor-48A/G genotypes and hemodynamic response to tracheal extubation in patients with essential hypertension（EH）.Methods One hundred and twenty adult patients with EH undergoing abdominal surgery were divided into three groups with 40 cases each,in whom dopamine D1 receptor-48A/G genotype was detected by RFLP-PCR.Groups of A and C were the patients with AG＋GG genotype and group B with AA genotype.The patients in group C were treated with nitroglycerin for deliberate hypotension before extubation.Anesthesia in all patients was induced and maintained with same techniques and drugs.SBP,DBP,HR and ECG were recorded at the end of surgery and at 0,1.5,5,and 15min after extubation.Results Compared with those at the end of operation,SBP,DBP and HR increased markedly in groups of A and B at 0,1.5,5 and 15min after extubation （P0.01 or P0.05）.At 0,1.5,5 and 15min after extubation,SBP was higher in group A than that in group C,and DBP was higher in group A than that in groups of B and C（P0.01）.The incidence of cardiac arrhythmias in group A was higher than that in groups of B and C（P0.05）.Conclusion The EH patients with AG genotype gene have strong hemodynamic response to tracheal extubation,on which nitroglycerin has a preventing and treating effect.

关 键 词：原发性高血压病 多巴胺受体D1-48A/G基因 

分 类 号：R614[医药卫生—麻醉学]