不同多巴胺D1受体基因型高血压患者气管插管反应的研究  

Research on hemodynamic response to endotracheal intubation in hypertensive patients of different dopamine D1 receptor genotypes

作　　者：王军[1] 王志萍[1] 黄东晓[1] 孙含哲[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：《临床麻醉学杂志》2011年第8期747-749,共3页Journal of Clinical Anesthesiology

基　　金：南京医科大学课题基金资助(08NMUM095)

摘　　要：目的研究不同多巴胺D1受体(DRD1)基因型48A/G原发性高血压患者全麻气管插管心血管反应。方法原发性高血压患者120例,ASAⅡ或Ⅲ级,按照基因型进行分组,A、C组为AG/GG型,B组为AA型,每组40例。C组气管插管前10 s静注乌拉地尔25 mg。于诱导前、诱导后、插管后0、1.5、5 min测定SBP、DBP、HR和ECG。结果与诱导前比较,A、B组插管后0、1.5、5min SBP、DBP升高,HR显著增快(P<0.05或P<0.01),C组SBP、DBP升高不明显。插管后0、1.5、5 min A组DBP明显高于、HR快于B、C组(P<0.05或P<0.01)。A组气管插管时心律失常发生率明显多于B、C组(P<0.05)。结论 AG/GG型原发性高血压患者气管插管时血流动力学变化明显,麻醉诱导前静注乌拉地尔可以起到预防作用。Objective To investigate hemodynamic response to endotracheal intubation under general anesthesia in patients of different dopamine D1 receptor -48A/G genotypes with essential hypertension （EH）. Methods One hundred and twenty patients with EH （ASA Ⅱ or Ⅲ） undergoing abdominal surgery were divided into three groups according to dopamine D1 receptor genotypes. The patients in group A and C were AG＋ GG genotype, and those in group B were AA genotype. 25mg Urapidil was intravenously injected 10s before intubation in group C. SBP, DBP, HR and ECG were recorded before and after induction, 0 min, 1.5 min and 5 min after intubation. Results Compared with baseline level before induction, SBP,DBP and HR at 0 rain, 1.5 min, 5 min after intubation increased significantly in group A and B （P〈0.05 or P〈0. 01）, whereas SBP,DBP did not increase significantly in group C. DBP and HR in group A increased more significantly at 0 min, 1.5 min, 5 rain after intubation compared with group B and C （P〈0. 05 or P〈0. 01）. The incidence of cardiac arrhythmias in group A was higher than that in group B and C （P〈0.05）. Conclusion EH patients of AG/GG genotype show significant hemodynamic fluctuation during endotracbeal intubation, which can be prevented by urapidil administration before anesthesia induction.

关 键 词：原发性高血压 多巴胺D1受体 气管插管 心血管反应 

分 类 号：R614[医药卫生—麻醉学]