艾司洛尔和乌拉地尔对高血压患者围拔管期皮质醇和泌乳素的影响

Effects of urapidil and esmlol on the plasma cortisol and lactotropin during intratracheal extubation of hypertensive

目的 探讨艾司洛尔与乌拉地尔对二期高血压患者围拔管期血浆皮质醇、泌乳素的影响。 方法按照高血压分期标准 ,将60例择期全麻手术患者分为4组 ,每组15例 ,分别为对照组 (Ⅰ、Ⅱ组 )和二期高血压组 (Ⅲ、Ⅳ组 )。气管拔管前6minⅠ、Ⅲ组静脉注射乌拉地尔0.5mg/kg;Ⅱ、Ⅳ组静脉注射艾司洛尔1.5mg/kg。分别在各组注药前、拔管前及拔管后1、5、10min抽血5mL,测定各时点血浆皮质醇、泌乳素的水平。结果 与用药前相比 ,Ⅰ、Ⅲ组拔管前、拔管后10min血浆皮质醇和泌乳素水平均无明显变化 (P>0.05) ;Ⅱ、Ⅳ组拔管后5、10min血浆皮质醇水平明显降低 (P<0.05) ,而泌乳素水平无明显变化。拔管后10min对照组 (Ⅰ、Ⅱ )与高血压组 (Ⅲ、Ⅳ )皮质醇水平的差别无显著性意义 (P>0.05) ,乌拉地尔组 (Ⅰ、Ⅲ )与艾司洛尔组(Ⅱ、Ⅳ)皮质醇水平的差别无显著性意义 (P<0.05)。结论 在预防围拔管期应激时 ,乌拉地尔和艾司洛尔对血浆泌乳素的影响较少。艾司洛尔能一定程度抑制血浆皮质醇的上升 ,有效地预防心、脑血管意外的发生。

Objective To observe the effects of Urapidil and Esmlol on the Plasma Cortisol Lactotropin levels during intratracheal extubation of hypertensive.Methods Sixty patients were divided into four groups according the standerd of hypertension at random.There were15cases in each group.As control groups(groupⅠ;groupⅡ),secondary hypertensive groups(groupⅢ;groupⅣ).All patients were received general anesˉthesia with endotracheal intubation.Six minutes before extubation,groupⅠand groupⅢwere injected intraˉvenous with Urapidil0.5mg/kg;groupⅡand groupⅣwere injected intravenous with Esmlol1.5mg/kg.The plasma Cortisol and Lactotropin were recorded,before operation,the time of intravenous injection,during extuˉbation,and1,5,10minutes after extubation respectively.Results The plasma Cortisol Lactotropin of groupⅠand groupⅢduring extubation and after extubation10min.have no changes compared with those before intraˉvenous injection.(P>0.05).However the plasma Cortisol of groupⅡand groupⅣafter extubation5min.and10min.were decreased significantly compared with those before intravenous injection(P<0.05).The changes of the plasma Cortisol after extubation10min.of groupⅠand groupⅡare same as those of groupⅢand groupⅣ(P>0.05),with2×2factorial experiment and analysis,the plasma Cortisol after extubation10min.of groupⅡand groupⅣwere decreased significantly compared with those of groupⅠand groupⅢ(P<0.05).Those have no function of intersection with hypertension,and have action on using of esmlol.Conclusion Uˉrapidil and esmlol have less effects on the plasma lactotropin levels during intratracheal extubation.Using of esmlol,the plasma cortisol level were restrained effectively after extubation.