老年冠心病患者围手术期血管活性物质的变化

Changes in concentration of vascular bioactive substances in senile CHD patients in perioperative periods

目的 探讨老年冠心病患者围手术期血管活性物质水平的变化规律及与围手术期发生心血管事件的关系。 方法 用放射免疫方法测定老年冠心病患者围手术期静脉血内皮素（ET）、血栓素A2（TXA2）、前列环素（PGI2）浓度,并以非手术的内科冠心病患者作对照。结果 与非手术的冠心病对照组及术前比较,手术组病人的内皮素、血栓素A2浓度在术中、术后24小时及72小时显著增高,前列环素减低。其高峰出现在术后24小时。结论 老年冠心病患者静脉血内皮素、血栓素A2、前列环素的浓度在围手术期均发生明显变化,对围手术期心血管事件的发生有重要影响。

Objective To explore the changes in concentration of vascular bioactive substances and their relations to perioperative cardiovascular events in the elderly patients with coronary heart disease (CHD). Methods We measured plasma concentrations of endothelin(ET), thromboxane A2(TXA2) and prostacyclin I2(PGI2) in elderly CHD patients and in medical CHD subjects with radioimmunoassay. The results from the two groups were comparatively analysed. Results In comparasion with non-surgical group and preoperative group , the plasma concentrations of ET and TXA2 in surgical patients with CHD were significantly increased intraoperatively, and 24 and 72 hours after the surgery. The peak concentration was at 24 hours after surgery. Conclusions The plasma concentrations of ET,TXA2 and PGL2 in elderly coronary heart disease patients changed significantly in perioperative periods. These might produce a great impact on the occurrence of perioperative cardiovascular events.