尼卡地平对高血压患者围术期的心肌保护作用

目的 研究尼卡地平对高血压患者围术期降压效果及其对心肌的保护作用。方法 40例择期行上腹部手术高血压患者随机分为尼卡地平组（N组）和对照组（C组）,C组仅接受麻醉药;N组诱导前3min静注尼卡地平10-20μg/kg-1,随后持续静脉泵注0.5-1.5μg/（kg·min）,观察给药前后患者心率、血压及心率收缩压乘积的变化,并于手术前、后1h分别采血用单克隆抗体酶联免疫法检测血清cTnI浓度。结果 N组cTnI浓度术后无明显增加（P〉0.05）,C组则明显高于术前（P〈0.01）;两组间差异有显著性（P〈0.01）,且N组有效抑制了气管插管时的心血管反应,与C组比差异有显著性（P〈0.01）。结论 尼卡地平不但有效抑制气管插管所致的心血管反应,并能预防和减少围术期心肌损伤的发生。

Objective To determine the value of using Nicardipine to prevent and treat myocardial isehemia in hypertensive patients. Methods Forty patients undergoing abdominal surgery were randomly divided into two groups treated with Nicardipine （N group , 20 patients） or without Nieardipine （C group , 20 patients） . The N - group administered 10 - 20ug/kg of Nieardipine iv 3 min before induction and Nieardipine 0.5 - 1.5ug/kg- 1/rain - 1 also infused during operation. The C - group used 0.9% NS as substitute. The blood pressure and heart rate（HR） were recorded , and rate - pressure product （RPP） was counted. Blood from peripheral vein was withdrawn at three points（before operation, after operation and 24h after operation） for cardic troponin I （cTn I） marker. Results The CTnl marker didn＇t increase significantly after operation（ P 〉 0.05） . Serum the CTnl marker elevated significantly in C- group than in preoperation （ P 〈 0.01 ） . There were significant differed between the two groups（ P 〈 0.01 ）, and in N group, ca.,＇diovaseular effects was effectively inhibited from intubation controlling, compare with C , the difference was significant （ P 〈 0.01 ）. Conclusion Nieardipine not only effectively helps to control cardiac vascular reaction during intubation, it also reduces and prevents the onset of perioperative myocardial damage in hypertensive patients.