缩宫素对子宫肌瘤剜除术患者血流动力学、血清一氧化氮和内皮素-1的影响

The effect of oxytocin on hemodynamic,nitrogen oxide and endothelin-1 in serum of patients with underwent myomectomy

目的观察缩宫素对子宫肌瘤剜除术患者血流动力学的影响及血清中一氧化氮和内皮素水平的变化。方法观察30例子宫肌瘤患者,分别于注射缩宫素前1 min(T1)、注射后1 min(T2)、注射后5 min(T3)记录患者收缩压、舒张压、心率和脉搏血氧饱和度,并分别于肘正中静脉采集外周血4 ml用于检测血清一氧化氮和内皮素-1水平。结果与T1时相比,T2时收缩压、舒张压显著下降(P<0.05),心率显著升高(P<0.05),T3时收缩压、舒张压、心率差异无统计学意义(P>0.05);各时间点脉搏血氧饱和度差异无统计学意义(P>0.05)。T2时一氧化氮水平(99±57)μmol/ml与T1时一氧化氮水平(149±49)μmol/ml相比显著下降(P<0.05);T3时一氧化氮水平(149±46)μmol/ml与T1时一氧化氮水平(149±49)μmol/ml相比差异无统计学意义(P>0.05)。T2时内皮素-1水平(104±19)pg/ml与T1时内皮素-1水平(88±21)pg/ml相比显著升高(P<0.05);T3时内皮素-1水平(88±19)pg/ml与T1时内皮素-1水平(88±21)pg/ml相比差异无统计学意义(P>0.05)。结论肌瘤周围注射缩宫素可引起一过性血压降低、心率增加,同时会导致血清中一氧化氮水平降低和内皮素-1浓度一过性升高,提示血清一氧化氮降低和内皮素-1升高可能为血压降低的反射性调节作用。

Objective To investigate the effect of oxytocin on the changes of hemodynamic,NO and ET-1 in serum of patients with myomectomy.Methods This study included 30 patients with selective myomectomy,electrocardiogram（ECG）,heart rate（HR）,blood pressure（BP）,the pulse oxygen saturation（SpO2） were continuousuy monitored.20 u oxytocin were injected around fibroids before myomectomy.1min before oxytocin injection（T1）,1min after injection（T2） and 5min after injection（T3） the data of SBP,DBP,HR and SpO2 were recorded.At the same time,4 ml peripheral blood were collected for testing serum Nitric Oxide（NO） and Endothelin-1（ET1） level.All data were analyzed with SPSS 13.0.Results 1.Hemodynamic changes： Compared with the T1,SBP and DBP at T2 significantly decreased（P〈0.05）,HR significantly increased（P〈0.05）;SBP,DBP and HR at T3 have no significant changes in（P〉0.05）;All periods SpO2 have no significant difference（P〉0.05）.2.NO level Changes：NO at the T2 significantly decreased（P〈0.05） than T1;NO at T3 and at T1 have no significant difference（P〉0.05）.3.ET-1 level changes： ET-1 at T2 significantly increased than T1（P〈0.05）;ET-1 at T3 and T1 have no significant difference（P〉0.05）.Conclusion Application of oxytocin arourd myomectomy caused the hemodynamic changes.Application of oxytocin can cause changes of the level of NO and ET-1 in the serum.The changes of NO and ET-1 have relation with the regulation of blood pressure.