糖尿病患者血浆SP和CGRP浓度与术中心血管事件的关系

Relationship between plasma substance P and calcitonin gene-related peptide concentrations and intraoperative cardiovascular events in diabetic patients

【摘要】目的评价糖尿病患者血浆P物质（sP）和降钙素基因相关肽（CGRP）浓度与术中心血管事件的关系。方法选择椎管内麻醉下行膝关节置换术的2型糖尿病患者22例为糖尿病组（DM组），另取椎管内麻醉下行膝关节置换术的非糖尿病患者22例为非糖尿病组（NDM组），2组患者ASA分级I或Ⅱ级，年龄50～77岁，性别不限。根据术前是否并存心血管疾病分为2个亚组（n=11）：未并存心血管疾病亚组（NDM—NCVD亚组和DM—NCVD亚组）和并存心血管疾病亚组（NDM—CVD亚组和DM—CVD亚组）。于术前30min和术毕时采用ELISA法测定血浆sP和CGRP浓度，术前30min和术后24h时采用ELISA法测定血浆cTnI浓度。记录术中心血管事件的发生情况。结果与NDM组比较，DM组术中心血管事件发生率、各时点血浆cTnI浓度升高，血浆SP和CGRP浓度降低（P〈0．05）。与DM．NCVD亚组比较，DM—CVD亚组术中心血管事件发生率、各时点血浆cTnI浓度升高，血浆SP和CGRP浓度降低（P〈0．05）。结论糖尿病患者术中心血管事件的发生与血浆sP和CGRP浓度降低有关。

Objective To evaluate the relationship between plasma substance P （SP） and calci- tonin gene-related peptide （CGRP） concentrations and intraoperative cardiovascular events in diabetic pa- tients. Methods Twenty-two patients of either sex with type 2 diabetes mellitus and 22 non-diabetic pa- tients of either sex, of American Society of Anesthesiologists physical status I or Ⅱ , aged 50-77 yr, un- dergoing elective knee arthroplasty under neuraxial anesthesia, served as diabetes mellitus group （group DM） and non-diabetes mellitus group （group NDM） , respectively. The patients of either group were fur- ther divided into 2 subgroups （n = 11 each） according to whether or not the patients had cardiovascular dis- eases before operation： no cardiovascular disease subgroups （NDM-NCVD subgroup and DM-NCVD sub- group） and cardiovascular disease subgroups （NDM-CVD subgroup and DM-CVD subgroup）. The plasma SP and CGRP concentrations were dertermined by enzyme-linked immunosorbent assay at 30 min before op- eration and at the end of operation. The plasma cardiac troponin I （cTnI） concentrations were measrued by enzyme-linked immunosorbent assay at 30 min before operation and 24 h after operation. The development of intraoperative cardiovascular events was recorded. Results Compared with group NDM, the incidence of intraoperative cardiovascular events and plasma cTnI concentrations at each time point were significantly in- creased, and the plasma concentrations of SP and CGRP were decreased in group DM （P〈0.05）. Com- pared with group DM-NCVD, the incidence of intraoperative cardiovascular events and plasma cTnI concert-trations at each time point were significantly increased, and the plasma concentrations of SP and C（;RP were decreased in group DM-CVD （P〈0.05）. Conclusion The development of intraoperative cardiovas- cular events is related to the decrease in plasma concentrations of SP and CGRP in diabetic patients.