糖尿病患者围手术期血清神经肽Y水平与不良心血管事件相关性分析  

Correlation analysis of perioperative serum neuropeptide Y levels with adverse cardiovascular events in diabetic patients

作　　者：苗清华 张美峰 雷易 郭政[1,2] Miao Qinghua;Zhang Meifeng;Lei Yi;Guo Zheng(Department of Anesthesiology,Shanxi Medical University,Taiyuan 030001,China;Department of Anesthesiology,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学麻醉学系,太原030001 [2]山西医科大学第二医院麻醉科,太原030001

出　　处：《国际麻醉学与复苏杂志》2021年第7期717-720,共4页International Journal of Anesthesiology and Resuscitation

摘　　要：目的:探讨神经肽Y(neuropeptide Y, NPY)水平与不良心血管事件(adverse cardiovascular events, ACVE)的相关性。方法:选择椎管内麻醉下行髋关节或膝关节置换术的102例患者,ASA分级Ⅰ、Ⅱ级,年龄43~82岁。根据术前是否合并2型糖尿病(diabetes mellitus, DM)将患者分为糖尿病组(DM组,49例)和非糖尿病组(NDM组,53例)。再基于术前是否伴心血管疾病(cardiovascular disease, CVD)分为4个亚组:DM合并CVD亚组(DM-CVD亚组)、DM未合并CVD亚组(DM-NCVD亚组)、非DM合并CVD亚组(NDM-CVD亚组)、非DM未合并CVD亚组(NDM-NCVD亚组)。采用ELISA法测定术前30 min、术毕和术后24 h血清NPY含量。记录分析围手术期ACVE发生情况,采用Spearsman相关分析评价患者血清NPY含量与ACVE的关系。结果:DM组围手术期总ACVE发生率高于NDM组(65.30%比30.19%, P<0.05);与DM-NCVD亚组比较,DM-CVD亚组围手术期ACVE发生率较高(44.44%比77.42%, P<0.05);与NDM-NCVD亚组比较,NDM-CVD亚组围手术期ACVE发生率较高(17.86%比44.00%, P<0.05)。与NDM组比较,DM组各时点血清NPY增高( P<0.05);与同组术前30 min比较,DM组术毕血清NPY明显升高( P<0.05);与未发生ACVE患者比较,发生ACVE患者各时点血清NPY明显增高( P<0.05)。DM组和NDM组患者各时点血清NPY水平与ACVE均有相关性( P<0.05)。 结论:DM患者围手术期ACVE发生率升高与血清NPY升高相关。Objective To investigate the correlation between perioperative neuropeptide Y(NPY)levels and adverse cardiovascular events(ACVE).Methods One hundred and two patients,American Society of Anesthesiologists(ASA)physical statusⅠorⅡ,aged 43-82 y,undergoing hip or knee replacement under intrathecal anesthesia,were enrolled and assigned into two groups:diabetic group(DM,n=49)and non-diabetic group(NDM,n=53),according to whether the patients carried type 2 DM.The two groups of patients were further assigned into four subgroups:DM group was divided into cardiovascular disease(CVD)group(DM-CVD)and non-CVD group(DM-NCVD),non-DM group was also divided into two groups:the subgroup with cardiovascular disease named NDM-CVD while non-DM group without cardiovascular disease named NDM-NCVD group.Intraoperative cardiovascular events were recorded and analyzed.Serum concentrations of NPY were determined by enzyme-linked immunosorbent assay(ELISA)at the time point:30 min before operation,the end of surgery and 24 h after operation.The incidence of perioperative ACVE was recorded and analyzed,and the correlation between the concentration of serum NPY and the incidence of ACVE was analyzed by Spearsman correlation analysis.Results The perioperative total ACVE incidence in the DM group was higher than that in the NDM group(65.30%vs.30.19%,P<0.05);compared with the DM-NCVD subgroup,the DM-CVD subgroup had a high incidence of ACVE during the perioperative period(44.44%vs.77.42%,P<0.05);compared with NDM-NCVD subgroup,the NDM-CVD subgroup had a high incidence of ACVE during the perioperative period(17.86%vs.44.00%,P<0.05).Compared with the NDM group,the serum NPY at each time point in the DM group was significantly increased(P<0.05);compared with the preoperative level in the same group,the serum NPY after the operation was significantly increased in the DM group(P<0.05);compared with patients without ACVE,the serum NPY levels of patients with ACVE were significantly increased at each time point(P<0.05).The serum NPY levels of patient

关 键 词：糖尿病 神经肽Y 围手术期 不良心血管事件 

分 类 号：R587.1[医药卫生—内分泌]