血液稀释对控制性降压下血清胱抑素C的影响

The effect of hemodilution on cystatin C during controlled hypotension

目的探讨急性等容性血液稀释对控制性降压期间血清胱抑素(Cys-C)的影响。方法选择40例择期脊柱手术病人,随机分为4组,对照组、控制性降压组、血液稀释组和血液稀释联合控制性降压组,每组10例。用0.01%硝普钠进行控制性降压,将MAP维持在60～70mmHg;通过静脉采血和输液进行血液稀释,将Hct降至25%～30%;测定Cys-C含量。结果控制性降压组Cys-C含量明显升高(P<0.05)。结论单纯控制性低血压可使肾小球滤过率(GFR)降低,而联用血液稀释则对肾功能有保护作用。

Objective To investigate the effect of acute isovolemic hemodilution on cystatin C during controlled hypotension.Methods 40 patients underwent spinal operation were randomly divided into 4 groups：control group,controlled hypotension group,hemodiluton group and hemodilution combined with controlled hypotension group.Controlled hypotension was induced with 0.01% sodium nitroprusside and the MAP was reduced to 60～70 mmHg.In hemodilution group and hemodilution combined with controlled hypotension group,the blood was removed from vein until the Hct was reduced to 25%～30% and the normovolemia was maintained by simultaneously infusion of Ringer＇s lactate solution.The cystatin C（Cys-C） levels were measured in all groups.Results The Cys-C levels of controlled hypotension group were dramatically higher than those of the other groups（P0.05）.Conclusion Controlled hypotension could decrease renal blood flow and hemodilution had the protective effects on renal function.