目标导向液体治疗对妇科手术患者血管保护作用及miRNA-126的影响

目的探讨目标导向液体治疗对妇科手术患者血管保护作用及miRNA-126的影响。方法选取择期行妇科手术患者260例，分干预组和对照组各130例，术中监测液体出入量，术前及术后3d检测血浆内皮素-1（ET-1）、一氧化氮（NO）、丙二醛含量（MDA）、超氧化物歧化酶（SOD）及8-异前列腺素F2d（8-iso-PGF2α），术后比较miRNA-126基因表达水平。结果与术前比较，两组患者ET-1、MDA、8-iso-PGF2α均在术后3d升高（P〈0．05）。而NO、SOD则降低（P〈0．05），干预组术后3dET-1、MDA、8-iso-PGF2α水平低于对照组（P〈0．05），而NO、SOD则高于对照组（P〈0．05），干预组miRNA-126基因表达明显上调（P〈0．05）。结论参数指导实施目标导向的液体治疗，能减少应激反应对血管内皮损伤的程度，并减少住院天数及围手术期并发症。

Objective To investigate the effect of goal-directed fluid therapy （ GDFT ） on vascular protection and miRNA-126. Methods 260 cases of gynecologic surgery patients were selected and divided into two groups： 130 cases with gynecological surgery and 130 case controlled with race, age, BMI, fasting plasma glucose and insulin levels as matched controls. The liquid management, serum markers （ ET-1, NO, MDA、 SOD and 8-iso-PGF2α） and miRNA-126 after surgery in two groups were recorded. Results The ET-1, MDA, 8-iso-PGF2α after 3 days of surgery in two groups were higher than before. The ET- 1, MDA, 8-iso-PGF2α after 3 days of surgery in Group GDFT were higher than that in Group control. While the relative quantification ofmiR-126 in Group GDFT was 3.10 times more than that in Group control. Conclusions Goal-directed fluid therapy （ GDFT ） can reduce vascular restenosis and help to reduce the inflammatory reaction.