不同全麻诱导药对高血压病人围诱导期血浆中四种神经肽的影响  

Effect of the different intravenous anesthetics on the levels of four neuropeptides in patients with hypertension during induction

作　　者：王显春[1] 吴颖川[1] 钟飞焱[1] 王锐[1] 赵国庆[2] 

机构地区：[1]深圳市红十字会医院麻醉科,518035 [2]吉林大学中日联谊医院麻醉科

出　　处：《中华麻醉学杂志》2002年第2期84-86,共3页Chinese Journal of Anesthesiology

摘　　要：目的 探讨不同全麻诱导药对高血压病人围诱导期血浆4种神经肽的影响。方法 择期上腹部手术的高血压病从60例,随机分为硫喷妥钠组（S组）、依托咪酯组（E组）和异丙酚组（P组）,每组20例。分别于麻醉前、诱导后2min、插管后2min、10min测定血浆中ET、CGRP、NPY、NT的含量及血液动力学变化。结果 诱导后S组和P组血压均下降,插管后S组和E组血压和心率均明显升高,与术前相比有显著差异（P<0.05或0.01）。诱导后S组和P组病人血浆ET、NPY降低、CGRP、NT明显升高,插管后S组和E组各项指标与术前相比均明显增高（P<0.05或0.01）,而插管后各指标P组与术前相比无差异,与其它组相比差异显著（P<0.05）。结论 异丙酚是高血压患者麻醉诱导的最佳选择。ve To assess the effects of the different intravenous anesthetics on the plasma levels of four neuropeptides in patients with hypertension during induction in order to find the best intravenous induction agent for the hypertension. Methods Sixty patients with hypertension ( SBP > 160mmHg, DBP>95mmHg) were randomly divided into 3 equal groups of 20 each : thiopental group, etomidate group and propofol group. All patients were prmedicated with intramuscular phenobarbital 0. 1g and atropine 0.5mg. Anesthesia was induced with thiopental 4mg·kg-1 or etomidate 0.3mg·kg-1 or propofol 2mg·kg-1, midazolam 0.1mg·kg-1, fentanyl 5μg·kg-1 and vecuronium 0.1mg·kg-1 and maintained with isoflurane inhalation and intermittent boluses of fentanyl and vecuronium. Blood samples were taken before anesthesia(To), 2min after induction(T1) and 2 and 10 min after tracheal intubation (T2, T3) for determination of plasma levels of endothelin(ET), calcitonin gene-related peptide(CGRP), neuropeptide Y (NPY) and neurotensin (NT). Results The three groups were compared with regard to age, sex and weight. BP significantly decreased after induction with thiopental or propofol but increased significantly after intubation in thiopental group and etomidate group. ET and NPY decreased but CGRP and NT increased significantly after induction in thiopental and propofol group. The plasma levels of all four neuropeptides increased significantly after tracheal intubation in thiopental and etomidata group but remained unchanged in propofol group. Conclusions Propofol is the intravenous anesthetic of choice for induction of anesthesia in patients with hypertension.

关 键 词：全麻诱导药 高血压 围诱导期血浆 神经肽 硫喷妥 异丙酚 依托咪酯 ET CGRP NPY NT 

分 类 号：R614.2[医药卫生—麻醉学]