舒芬太尼预处理对臂丛神经阻滞高血压患者心肌损伤的影响

发布时间：2018-08-02 11:21

【摘要】：目的:探讨舒芬太尼预处理对行臂丛神经阻滞高血压患者心肌损伤的影响。方法:选择择期行臂丛神经阻滞的高血压患者60例,术前经内科规范治疗,将血压控制在择期手术要求范围内。将以上患者随机均分为A、B、C三组,于臂丛神经阻滞前分别给予相同容量的生理盐水(A组)、舒芬太尼0.1μg/kg(B组)、舒芬太尼0.2μg/kg(C组),记录各组患者给药前(T_0)、给药后3 min(T_1)、给药后5 min(T_2)及给药后30 min(T_3)的心率(HR)和平均动脉压(MAP)。并于给药前(T_0)和给药后24 h(T_4)两时点采取静脉血测定血清肌钙蛋白I(cTnI)以及肌酸激酶同工酶(CK-MB)的浓度。结果:三组患者的HR及MAP在各时点差异均无统计学意义(P0.05);三组患者的血清cTnI及CKMB的浓度,T_4时点比T_0时点显著升高(P0.05);在T_4时点,与A组相比,C组cTnI以及CK-MB的浓度显著降低(P0.05),与B组相比,cTnI以及CK-MB的浓度差异无统计学意义(P0.05);B组与A组相比,cTnI以及CK-MB的浓度差异无统计学意义(P0.05)。结论:舒芬太尼预处理在稳定血流动力学的同时又能够降低血清cTnI以及CKMB的水平,B组对cTnI及CK-MB的释放抑制作用较弱,而C组对cTnI及CK-MB的释放抑制作用较强,血流动力学虽有波动但仍在正常范围内,故0.2μg/kg的舒芬太尼预处理能够降低臂丛神经阻滞高血压患者心肌的损伤,对心肌有一定的保护作用。
[Abstract]:Objective: to investigate the effect of sufentanil preconditioning on myocardial injury in hypertensive patients with brachial plexus block. Methods: 60 patients with hypertension undergoing brachial plexus block were selected. The above patients were randomly divided into three groups: Agna BX C group. The same volume of normal saline (group A), sufentanil 0.1 渭 g/kg (group B) and sufentanil (group C) were given before brachial plexus block, respectively. The heart rate (HR) and mean arterial pressure (MAP).) were recorded before administration (T0), 3 min (T1) after administration, 5 min (TV2) after administration and 30 min (T3) after administration of sufentanil. The concentrations of serum troponin I (cTnI) and creatine kinase isoenzyme (CK-MB) were measured in venous blood at two time points before and 24 hours after administration. Results: there was no significant difference in HR and MAP between the three groups at each time point (P0.05), the concentrations of serum cTnI and CKMB in the three groups were significantly higher than those in T _ (0) time (P0.05), and the serum cTnI and CKMB concentrations in the three groups were significantly higher than those in T _ (0) time (P0.05). Compared with group A, the concentrations of cTnI and CK-MB in group C were significantly lower than those in group A (P0.05), but there was no significant difference in the concentrations of TnI and CK-MB between group B and group B (P0.05). There was no significant difference in the concentrations of cTnI and CK-MB between group B and group A (P0.05). Conclusion: sufentanil pretreatment can stabilize hemodynamics and decrease the level of serum cTnI and CKMB. Group B has a weaker inhibitory effect on the release of cTnI and CK-MB, while group C has a stronger inhibitory effect on the release of cTnI and CK-MB. Although hemodynamics fluctuates, it is still within normal range, so sufentanil pretreatment with 0.2 渭 g/kg can reduce myocardial injury in brachial plexus block patients with hypertension, and has a protective effect on myocardium.
【作者单位】：山西医科大学;山西医科大学第二医院;
【分类号】：R544.1

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