体外循环心内直视术中应激指数与血浆儿茶酚胺的相关性研究  

Correlation between SSI-S and plasma catecholamines during open heart surgery with cardiopulmonary bypass

作　　者：徐平平[1] 刘苹 XU Pingping;LIU Ping(Department of Anesthesiology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院麻醉科,武汉430022

出　　处：《临床外科杂志》2021年第12期1139-1142,共4页Journal of Clinical Surgery

摘　　要：目的研究体外循环(CPB)心内直视术中应用多功能组合式监护仪(HXD-1)及眶上动脉血流传感器,监测应激指数(SSI-S)与血浆儿茶酚胺的相关性,以探讨连续性无创监测病人术中应激反应的可能性。方法2018年3月~2018年6月我院择期行CPB心内直视术病人27例,连接HXD-1及眶上动脉血流传感器,监测CPB前即刻(T1)、CPB 5分钟(T2)、CPB 10分钟(T3)、CPB 15分钟(T4)、停CPB(T5)时SSI-S,分别于T1~T5各时间点测定动脉血中血糖、血浆中肾上腺素和去甲肾上腺素的浓度,利用协方差分析计算SSI-S与应激反应生化指标的相关性。结果SSI-S与血浆肾上腺素、去甲肾上腺素和血糖浓度成正相关,SSI-S与肾上腺素、去甲肾上腺素和血糖的相关系数分别为0.69,0.72,0.77;R^(2)分别为0.736,0.706,0.61;P<0.001。结论在CPB心内直视术中SSI-S与血浆肾上腺素,去甲肾上腺素和血糖水平有很好的相关性,有可能成为一种连续性无创监测术中应激反应的一种监测手段。Objective To investigate the correlation of stress index with plasma catecholamines in the application of multi-functional combined monitor HXD-1 and supraorbital artery blood flow sensor in open heart surgery during cardiopulmonary bypass,so as to explore the possibility of continuous noninvasive monitor.Methods From March 2018 to June 2018,twenty-seven patients undergoing open heart surgery with cardiopulmonary bypass,connecting HXD-1 and supraorbital artery blood flow sensor to monitor stress index(SSI-S)at immediately before cardiopulmonary bypass(CPB)(T1),CPB 5 min(T2),CPB 10 min(T3),CPB 15 min(T4),and CPB(T5).The blood glucose(Glu),plasma epinephrine(E)and norepinephrine(NE)were obtained at five time points.The correlation between SSI-S and biochemical indicators of stress response were calculated using covariance analysis.Results Through covariance analysis,the SSI-S were positively correlated with the plasma concentration of epinephrine,norepinephrine and blood glucose.The correlation coefficients between SSI-S with epinephrine,norepinephrine and blood glucose were 0.69,0.72,0.77,respectively.The square of R were 0.736,0.706,0.61,respectively.All P<0.001.Conclusion SSI-S showed a good correlation with plasma epinephrine,norepinephrine and blood glucose levels in open heart surgery during cardiopulmonary bypass,and may apply to monitor continuous noninvasive monitoring of intraoperative stress response.

关 键 词：体外循环 应激指数 儿茶酚胺 肾上腺素 去甲肾上腺素 血糖 

分 类 号：R654.1[医药卫生—外科学]