全麻手术对肥胖患者血浆抵抗素和肾素血管紧张素及血糖的影响

The effect of general anesthesia and surgery on plasma resistin,renin-angiotensin and blood sugar concentration in fat obesity

目的 研究全麻诱导以及手术对肥胖患者血浆抵抗素 (resistin)和肾素、血管紧张素Ⅱ及血糖的影响。方法 选择 4 0例全麻手术患者 ,根据BMI指数分为两组 :A组 (BMI>2 5 ) 2 0例为肥胖者 ;B组 (2 1 <BMI<2 5 ) 2 0例为正常体重。于诱导前 2 0min和诱导后 1 0min ,切皮后 1 0min ,重大手术操作时 ,手术结束后 1 5min分别抽取患者外周静脉血测定血浆抵抗素和尾加压素浓度。结果麻醉诱导前 ,A组血浆抵抗素浓度、肾素及血管紧张素Ⅱ和血糖浓度与B组无明显差异 ;与手术前比较 ,麻醉手术期间两组血浆抵抗素浓度均有下降 (P <0 0 5 ) ,而肾素及血管紧张素Ⅱ和血糖浓度均升高 ;与B组比较 ,A组术中血浆抵抗素浓度明显下降 (P <0 0 1 )。结论 手术刺激可使血浆抵抗素浓度下降 。

Objective To investigate the effect of general anesthesia and surgery on plasma resistin, renin angiotensin and blood sugar concentration in fat obesity.Methods Forty patients(ASAⅠ Ⅱ)were randomly divided into two groups,20 fat patients (BMI>25)in group A and 20 normal weight patients(21<BMI<25)in group B.Plasma resistin,renin angiotensin and blood sugar concentration were measured at 20 min before intubate of anesthesia and 10 min after intubation,10 min after start of surgery,during operation and at 15 min after operation.Results The concentration of plasma resistin,renin angiotensin and blood sugar in group A was not significantly different from that in group B.Compared with preoperation,plasma resistin concentration decreased( P< 0 05)and rein angintensin Ⅱ and blood suger concentration increased during operation in both groups.Compared with group B,plasma resistin concentration in group A was significantly lower( P< 0 01).Conclusion Plasma resistin concentration is decreased by general anesthesia and surgical stimulation,especialy in the obesity.