前列环素血栓素含量和糖代谢的相关性研究

The Study of Correlation Between Carbohydrate Metabolism and Concentration of Prostaglandin I_2 and Thromboxane A_2

目的 探讨体外循环(CPB)期间前列环素(PGI2 )、血栓素 (TXA2 )含量及其比值与糖酵解产物血乳酸含量之间的相关关系及可乐定对其的影响。方法 CPB下行择期心脏手术患者 30例,随机分为可乐定组与对照组。两组病人分别于麻醉前、转流前、转流 30min、60min、90min、120min及转流停止后 30min各采集桡动脉血标本测定PGI2、TXA2 含量及血乳酸含量。以PGI2、TXA2 及PGI2 /TXA2 比值为自变量x1、x2 及x3,血乳酸为因变量Y,进行多元直线相关回归分析,并作显著性检验。回归方程为Y=a+b1x1 +b2x2 +b3x3。结果 简单相关系数显示,各变量间的相关系数均有极显著性意义(P<0. 01),两组之间相关系数比较,可乐定组rY. 1、r1. 3的相关性明显高于对照组(P<0. 05),rY. 3、r1. 2相关性极明显高于对照组(P<0. 01)。偏相关系数显示,两组的PGI2含量均与血乳酸含量(rY1. 2)呈极显著性意义负相关(P<0. 01);两组的TXA2 含量均与血乳酸含量〔rY2. 1〕呈极显著性意义正相关(P<0. 01),三个自变量间的偏相关系数显示,PGI2 /TXA2 比值与PGI2〔r31. 2〕呈极显著性意义正相关(P<0. 01)、与TXA2 (r32. 1)呈极显著性意义负相关(P<0. 01),两组比较,可乐定组的rY1.2、rY2. 1相关性极明显高于对照组(P<0. 001)。两组的三元线性回归方程效果检?

OBJECTIVE To study the correlation between carbohydrate metabolism and concentration of prostaglandin I 2(PG 2) and the thromboxane A 2(TXA 2) during cardiopulmonary bypass (CPB)and the influence of oral clonidine premedication.METHODS Thirty patients scheduled for cardiac surgery were randomly divided into two groups : clonidine group and control group.Oral premedication with clonidine 5μg/kg was taken in clonidine group 60 minute before anesthesia induction in addition to same routine premedications. Arterial plasma concentrations of PGI 2、TXA 2 and lactic acid were measured before anesthesia ,before CPB,30、60、90、120 min following CPB and 30 min after CPB .RESULTS The levels of PGI 2、TXA 2 and lactic acid increased significantly during CPB in both groups.There were evident correlation between every variable ,but these correlations were better in clonidine group than in control group,correlation between lactic acid and ratio of PGI 2 / TXA 2 was better markedly (P<0.01) in clonidine group(r = -0.93) than in control group(r = -0.82).Partial correlation coefficients revealed :lactic acid demonstrated a marked negative correlation with PGI 2 after excluding influence of TXA 2, and a marked positive correlation with TXA 2 after excluding influence of PGI2 at two groups.There was a better correlation in clonidine group than in control group(P<0.01).CONCLUSION As clonidine could increase the level of PGI 2 and improve the balance of ratio of PGI 2 / TXA 2 during CPB, therefore,improve microvasculature perfusion.As a result,the level of lactic acid decreased.