孤啡肽与老年冠心病患者围术期心肌损伤的相关性研究  

Correlation between nociceptin/orphanin FQ(N/OFQ)and perioperative myocardial injury in elderly patients with coronary heart disease

作　　者：朱丹艳 熊畅 彭文勇 许多嘉 蓝志坚 ZHU Danyan;XIONG Chang;PENG Wenyong;XU Duojia;LAN Zhijian(Department of Anesthesiology,Affiliated Jinhua Hospital,Zhejiang University School of Medicine,Jinghua 321000,Zhejiang,China)

机构地区：[1]浙江大学医学院附属金华医院麻醉科,浙江金华321000

出　　处：《中国现代医生》2024年第11期7-10,14,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2022KY1328);浙江省金华市科技计划项目(2021-4-004)。

摘　　要：目的评价老年冠状动脉粥样硬化性心脏病(以下简称冠心病)患者围术期心肌损伤(perioperative myocardial injury,PMI)与血清孤啡肽(nociceptin/orphanin FQ,N/OFQ)含量的关系。方法纳入2022年1月至2023年5月在全身麻醉下行髋部骨折手术的老年患者120例,其中冠心病(冠心病组)与非冠心病(对照组)患者各60例。分别于麻醉诱导前10min(T_(0))、术后12h(T_(1))以及术后24h(T_(2))采集患者静脉血检测血清中N/OFQ以及高敏心肌肌钙蛋白I(high-sensitivity myocardial troponin I,hs-cTnI)含量,记录围术期不良心血管事件(perioperative adverse cardiovascular events,PACE)及术中血管活性药物的使用情况。结果与对照组比较,冠心病组患者T_(0)及T_(1)时刻N/OFQ及hs-cTnI含量显著升高(P<0.05),冠心病组和对照组患者T_(1)及T_(2)时刻N/OFQ与hs-cTnI含量呈正相关(P<0.05),冠心病组患者PACE及术中血管活性药物使用均多于对照组差异有统计学意义(P<0.05)。结论老年冠心病患者术后N/OFQ含量升高与PMI存在正相关性,可能成为PMI的早期预测指标。Objective To evaluate the relationship between perioperative myocardial injury(PMI)and serum N/OFQ levels in elderly patients with coronary heart disease.Methods Totally 120 elderly patients who underwent hip fracture surgery under general anesthesia from January 2022 to May 2023 were included,including 60 patients with coronary heart disease(CHD group)and 60 patients without coronary heart disease(control group).The venous blood of patients was collected 10 minutes before anesthesia induction(T_(0)),12 hours after surgery(T_(1))and 24 hours after surgery(T_(2))to detect the content of N/OFQ and high-sensitivity myocardial troponin I(hs-cTnI)in serum.Record perioperative adverse cardiovascular events(PACE)and the use of vasoactive drugs during surgery.Results Compared with the control group,the N/OFQ and hs cTnI levels at T_(0)and T_(1)in the CHD group were significantly increased(P<0.05).There was a positive correlation between N/OFQ and hs-cTnI levels at T_(1)and T_(2)in CHD and control group(P<0.05).The use of PACE and intraoperative vasoactive drugs in the CHD group was higher than that in the control group(P<0.05).Conclusion There is a correlation between the increased N/OFQ content and PMI in elderly patients with coronary heart disease after surgery,which may become an early predictive indicator of PMI.

关 键 词：孤啡肽 冠心病 围术期心肌损伤 非心脏手术 

分 类 号：R541.4[医药卫生—心血管疾病]