糖尿病患者P物质、去甲肾上腺素改变与术中心血管事件风险相关性的研究

Research of correlation of substance P, change of noradrenaline and intraoperative cardiovascular events risk in diabetes mellitus patients

目的观察糖尿病患者进行膝髋关节置换术前、术毕血浆P物质(SP),去甲肾上腺素(NE)含量变化及其与患者术中发生心血管事件的相关性。方法 66例蛛网膜下腔阻滞下择期行膝髋关节置换术患者,分为非糖尿病组(NDM组)与糖尿病组(DM组),每组33例。术中监测记录无创血压、心率、心律、脉搏血氧饱和度、心电图及ST段。采用酶联免疫吸附法测定术前和术毕血浆SP、NE浓度。结果 DM组在术前、术毕时间点SP含量明显低于NDM组(P<0.05);术前时间点DM组NE含量较NDM组显著降低(P<0.05);发生术中心血管事件组血浆SP显著低于未发生心血管事件组(P<0.05)。结论糖尿病患者血浆SP、NE含量降低与术中心血管事件相关,其机制有待于进一步研究。

ObjectiveTo observe correlation of preoperative, postoperative plasma substance P （SP）, changes of noradrenaline （NE） and intraoperative cardiovascular events in diabetes mellitus patients receiving knee hip replacement.Methods A total of 66 patients with subarachnoid block receiving knee hip replacement were divided into non-diabetes mellitus group （NDM group） and diabetes mellitus group （DM group）, and each group contained 33 cases. Non-invasive blood pressure, heart rate, heart rhythm, saturation of pulse oximetry, electrocardiogram and ST segment were monitored during operation. Preoperative and postoperative plasma contents of SP and NE were detected by enzyme-linked immunosorbent method.Results DM group had obviously lower SP content in time points before and after operation than NDM group （P〈0.05）, and its NE content before operation was remarkably lower than NDM group （P〈0.05）. Cardiovascular events group had much lower plasma SP level than non-cardiovascular events group （P〈0.05）.Conclusion Decreased plasma SP and NE contents are correlated with intraoperative cardiovascular events in diabetes mellitus patients. Its mechanism requires further study.