Implications of Elevated Serum Cortisol in the Onset of Postoperative Delirium Following Off-Pump Coronary Artery Bypass Grafting: Insights from a Bangladesh-Based Single Center Experience

Background: Following coronary artery bypass grafting (CABG), delirium emerges as a prevalent complication. This study aimed to assess the correlation between elevated serum cortisol levels and the occurrence of postoperative delirium subsequent to off-pump CABG. Methods: Conducted in the Department of Cardiac Surgery at BSMMU from October 2020 to September 2022, this comparative cross-sectional study included a total of 44 participants. Subjects, meeting specific criteria, were purposefully assigned to two groups based on off-pump CABG. Group A (n = 22) consisted of patients with normal serum cortisol levels, while Group B (n = 22) comprised individuals with high serum cortisol levels on the first postoperative day. Delirium onset was assessed at the bedside in the ICU on the 1st, 2nd, 3rd, 4th, and 5th postoperative days using standard tools, namely the Richmond Agitation Sedation score (RASS) and The Confusion Assessment Method (CAM-ICU). Data were collected based on the presence or absence of delirium. Statistical analysis utilized SPSS version 26.0, employing an independent Student’s t-test for continuous data and chi-square and Fischer’s exact test for categorical data. A p-value ≤ 0.05 was considered statistically significant. Results: Group-A had a mean age of 54.50 ± 17.97, and Group-B had a mean age of 55.22 ± 15.45, both with a male predominance (81.81% and 86.36% respectively). The mean serum cortisol level was significantly higher in Group B (829.71 ± vs. 389.98 ± 68.77). Postoperative delirium occurred in 27.3% of Group B patients, statistically significant compared to the 4.5% in Group A. However, patients in Group B who developed delirium experienced significantly longer postoperative ICU and hospital stays (79.29 ± 12.27 vs. 11.44 ± 2.85, p ≤ 0.05). There was one mortality in Group B, which was statistically not significant. Conclusion: This study observed a significant association between elevated serum cortisol levels in the postoperative period and the occurrence of postoperative delirium after off-pump coronary artery bypass grafting.

Changes and Clinical Value of Serum Cortisol Levels in Patients with Hypertensive Disorder in Pregnancy

Objective:To investigate the changes and the corresponding clinical value of serum cortisol levels in patients with hypertensive disorders during pregnancy.Methods:In this study,90 patients with different degrees of hypertensive disorders during pregnancy who were admitted from August 2018 to August 2019 in our hospital were set as the research objects.90 cases were grouped according to the diagnostic criteria in Obstetrics and Gynecology,including 30 cases in each of the hypertension group,the preeclampsia group,and the eclampsia group.Another 30 healthy pregnant women were selected as the control group.The serum cortisol levels of pregnant women in the above four groups were measured.Results:Compared with the control group,the serum cortisol levels in the other three groups were significantly increased.In perinatal outcome,compared with the control group,the three groups of patients had an increase in Apgar score,preterm birth,stillbirth rate,growth restriction rate and neonatal asphyxia rate.There were significant differences between groups(P<0.05),and showed as gestational hypertension<preeclampsia<eclampsia.Conclusion:With the exacerbation of hypertensive disorders during pregnancy,the serum cortisol level continues to increase,which has a serious adverse effect on the prognosis of the perinatal infants.

Effects of Serum Cortisol Levels on Perinatal Prognosis in Patients with Hypertensive Disorder

Objective:To investigate the effect of serum cortisol level on perinatal prognosis in patients with hypertensive disorder during pregnancy.Methods:In this study,different degrees of patients with hypertensive disorder during pregnancy who were admitted from August 2018 to August 2019 in our hospital were selected as the research subjects,and divided into groups according to the severity of the patients’conditions.The 120 patients were divided into gestational hypertension group,preeclampsia group and eclampsia group,with 40 cases each,and another 40 healthy pregnant women were selected.The detection of serum cortisol levels was carried out for the above 4 groups of pregnant women.Results:The serum cortisol level in the control group was(260.35±10.96)nmol/L.The case number of neonatal asphyxia was 1(2.50%),the case number of premature births was 1(2.50%),the number of fetal growth restriction was 1(2.50%),the number of deaths was 0,and the other three groups were higher than this.It showed as gestational hypertension<preeclampsia<eclampsia.The Apgar score of pregnant women in the control group was(9.13±0.29),the ZL index was(1.07±0.07),and the other three groups were lower than this.It showed as gestational hypertension>preeclampsia>eclampsia.There were significant differences between groups(all P<0.05).Conclusion:Early detection of serum cortisol levels in pregnant women is beneficial to timely improve the symptoms of gestational hypertension,thereby suppressing the effects of serum cortisol on perinatal infants and improving the prognosis of newborns.

血清Cortisol和血浆AT-Ⅱ在围手术期开胸患者体内水平的探讨

目的:通过测定开胸患者术前及术毕血清皮质醇(Cortisol)和血浆血管紧张素Ⅱ(AT-Ⅱ)的水平,探讨应激前后开胸患者体内血清Cortisol和血浆AT-Ⅱ的变化。方法:无严重高血压、心脏病、垂体瘤及其它相关影响体内Cortisol、AT-Ⅱ水平疾病且具有手术指征的开胸患者35例(男18,女17),平均年龄(58.1±10.6)岁,分别在术前及术毕时采血,应用放射免疫分析测定血清Cortisol和血浆AT-Ⅱ的水平。结果:经配对t检验,结果显示开胸患者术毕血清Cortisol和血浆AT-Ⅱ与术前相比明显增高,存在显著性差异(t=-3.686～-3.575,P≤0.01);收缩压及心率,存在显著性差异(t=-2.35～4.72,P=0～0.025<0.05)。控制性别与年龄后,经部分相关分析,术毕心率与AT-Ⅱ呈显著正相关(r=0.41,P=0.035<0.05);与术毕Cortisol呈正相关(r=0.42,P=0.019<0.05)。结论:开胸患者术毕血清Cortisol、血浆AT-Ⅱ和心率明显增高。术后应密切监测开胸患者血清Cortisol及AT-Ⅱ的水平,作好相应的护理,以减少其它并发症的发生几率。

Association between endogenous cortisol level and the risk of central serous chorioretinopathy:a Meta-analysis

AIM： To assess the association between endogenous cortisol level and the risk of central serous chorioretinopathy（CSC）.METHODS： Case-control studies were systematically searched on PubM ed, Embase, Cochrane, China National Knowledge Infrastructure（CNKI） for publishes between January 1990 and July 2017 to assess the association between endogenous cortisol level and CSC. The main endpoints were serum cortisol level at 8 a.m. and 24-hour urine 17-hydroxysteroids level. We assessed pooled data using a random-effects model.RESULTS： Of 86 identified studies, 5 were eligible included in our analysis. The 5 studies included a total of 315 participants, of whom 187 had CSC. Statistically significant association was observed between serum cortisol level（summary SMD=0.77, 95%CI=0.55-0.99）, 24-hour urine 17-hydroxysteroids level（summary SMD=0.95, 95%CI=0.61-1.30）, and the risk of CSC.CONCLUSION： Endogenous cortisol level is associated with an increased risk of CSC. Combined treatment targeting the serum cortisol level at 8 a.m. and 24-hour urine 17-hydroxysteroids level can be a potential preventive strategy for individuals who are at risk of CSC and therapeutic strategy for patients with CSC.

The Variation in Plasma Cortisol Levels in Response to Anesthetic Induction with Etomidate or Ketamine in Children Undergoing Intracardiac Repair of Tetralogy of Fallot on Cardiopulmonary Bypass

Objective: To compare the effect of a single induction dose of etomidate or ketamine on plasma cortisol levels in children with Tetralogy of Fallot (TOF) undergoing intra-cardiac repair on cardiopulmonary bypass (CPB). Design: A prospective randomized trial. Setting: Cardiac center of a tertiary care hospital. Participants: Thirty children with TOF undergoing intra-cardiac repair on CPB. Interventions: After random allocation of the children into two groups, the children either received etomidate 0.2 mg/kg or ketamine 2 mg/kg intravenously for anesthetic induction along with fentanyl 2 mcg/kg and midazolam 100 mcg/kg. Endotracheal intubation was accomplished with rocuronium bromide in the dose of 1 mg/kg. Anesthesia was maintained with sevoflurane in air-oxygen, titrated to response and supplemental vecuronium bromide for muscle relaxation, fentanyl chloride for pain relief. Serum cortisol was measured on three occasions, at preinduction, at the end of surgery and at 24 hours postoperatively. Measurements and Main Results: Baseline plasma cortisol (Normal 5 - 25 mcg/dl) in the etomidate group (19.91 ± 3.51 mcg/dl) decreased significantly at the end of surgery (5.78 ± 2.0 mcg/dl) and rose to significantly higher than baseline values at 24 hours (27.31 ± 8.30 mcg/dl). The baseline cortisol levels in the ketamine group (20.91 ± 3.19 mcg/dl) increased significantly at the end of surgery (44.02 ± 5.49 mcg/dl) and remained significantly higher than baseline at 24hours (45.93 ± 3.05 mcg/dl). Plasma cortisol levels in the etomidate group at end of surgery, and at 24 hours post-operatively, were significantly lower than the ketamine group. Conclusions: This study shows that etomidate is a suitable and safe agent for suppression of the increase in serum cortisol associated with the use of CPB in children with TOF undergoing intra-cardiac repair.

血清皮质醇与血管性轻度认知障碍肾阳虚证患者认知功能的相关性研究

目的探讨血清皮质醇与血管性轻度认知障碍肾阳虚证患者认知功能之间的关系。方法选取64例血管性轻度认知障碍肾阳虚证患者。根据血清皮质醇中位数分为高皮质醇组和低皮质醇组,各32例,收集患者一般临床资料、血清皮质醇指标,并进行神经心理学量表及肾阳虚量表测评。采用相关性分析及线性回归分析探讨血清皮质醇与血管性轻度认知障碍肾阳虚证患者认知功能之间的关系。结果与低皮质醇组相比,高皮质醇组的高血压病、脑血管病比例更高,MoCA、MMSE、AESC量表评分更低(P<0.05),ADL、HAMD、肾阳虚证辨识量表评分更高(P<0.05)。相关性分析结果显示高皮质醇与ADL、HAMD、肾阳虚辨识量表评分均呈正相关,与MoCA、MMSE、AESC量表评分均呈负相关(P<0.001)。线性回归分析结果显示高皮质醇为MoCA量表评分的独立危险因素,血管性轻度认知障碍肾阳虚证患者的血清皮质醇水平越高,MoCA量表评分越低(P<0.001),认知损害越严重。结论血清皮质醇的升高可能是血管性轻度认知障碍肾阳虚证患者认知功能损害的潜在因素。

椎管内麻醉时咪达唑仑复合布托啡诺镇静对血糖和皮质醇及焦虑情绪的影响

【目的】观察椎管内麻醉时咪达唑仑复合布托啡诺镇静对患者血糖、皮质醇及焦虑情绪的影响,以探讨椎管内麻醉时复合静脉镇静的临床意义。【方法】40例在椎管内麻醉下手术的成年患者,随机分入镇静组(n=20)与对照组(n=20):镇静组按首量咪哒唑仑40μg/kg+布托啡诺15μg/kg及维持量每小时咪哒唑仑20μg/kg+布托啡诺7.5μg/kg给药;对照组为生理盐水按盲法要求给药。测定术前1d上午9时、入手术室后10min、手术开始后30min及手术结束时的血糖、血清皮质醇浓度;入手术室后15min、术后24h分别调查患者术前、术中的焦虑程度;记录麻醉前、给药后0、5、10、20、30、60min以及手术结束后0、10、20、30min患者的脑电双频谱指数(BIS)、镇静警觉评分(OAA/S)。【结果】麻醉前各项指标组间无统计学差异(P>0.05);镇静组患者术中OAA/S3～4分,BIS70～90,处于浅镇静状态;术中、术毕镇静组的血糖、皮质醇浓度明显低于对照组(P<0.05);镇静组术中的焦虑评分明显低于对照组(P<0.05)。【结论】椎管内麻醉期间咪达唑仑复合布托啡诺浅镇静能明显减轻患者的应激水平及焦虑程度。

蛛网膜下隙-硬膜外间隙联合阻滞(CSEA)应用于分娩镇痛的临床观察

目的 :研究蛛网膜下隙 硬膜外间隙联合阻滞 (CombinedSpinalEpiduralAnalgesia ,CSEA)应用于分娩镇痛的临床效果。方法 :90例初产妇按入院前后及个人同意分成三组。C组 :对照组 ,未用任何镇痛方法。CEA组 :0 .12 5 %罗哌卡因 + 2 μg /ml芬太尼组。CSEA组 :L2 /3CSEA联合穿刺成功后 ,蛛网膜下腔注入 0 .17%布比卡因 1ml + 2 .5 μg芬太尼 1ml,常规向头端置入硬膜外导管。观察产妇的分娩、镇痛情况及镇痛前后对产妇应激及泌乳的影响。结果 :1.CEA组和CSEA组产妇镇痛效果满意 ,和对照组比较有显著性差异 (P <0 .0 5 ) ,但CSEA组起效时间明显短于CEA组 ,且同一时点镇痛效果优于CEA组 (P <0 .0 5 ) ;2 .CSEA组产程活跃期为 14 2分钟和CEA组 15 3分钟短于均对照组 191分钟 ,有统计学差异 ;3.镇痛组与对照组比较无运动神经的阻滞 ;4 .三组产妇血浆皮质醇的浓度呈逐步上升趋势 ,CEA、CSEA组镇痛后比镇痛前的皮质醇含量变化不明显 (P >0 .0 5 ) ,对照组镇痛后比镇痛前的皮质醇含量明显升高 ,有统计学差异 (P <0 .0 5 ) ;5 .三组间各时点催乳素含量及产后泌乳始动时间差别不显著 (P >0 .0 5 )。结论 :CSEA和CEA都是行之有效的分娩镇痛方法 ,但CSEA起效迅速、镇痛完善、缩短活跃期产程。

促肾上腺皮质激素-皮质醇节律对肾上腺意外瘤亚临床库欣综合征的诊断价值

目的探讨促肾上腺皮质激素(ACTH)-皮质醇节律对肾上腺意外瘤(AI)中亚临床库欣综合征(SCS)的诊断价值和最佳诊断切点。方法收集2008年1月-2016年12月在解放军总医院内分泌科住院诊治的AI患者的病例资料,以目前国内外指南推荐的库欣综合征(CS)诊断标准+术后病理证实肾上腺皮质腺瘤为金标准,SCS为试验组,肾上腺无功能腺瘤(NFA)为对照组,采用受试者工作曲线(ROC)对ACTH-皮质醇节律的诊断价值进行评价并找出最佳切点。结果最终纳入SCS患者88例,其中男26例、女62例,平均就诊年龄为51.02岁;NFA患者161例,其中男84例、女77例,平均就诊年龄为51.74岁。皮质醇(F)0:00am的曲线下面积最大,为0.841(95%CI 0.792~0.890,SE=0.025),最佳切点为113.35nmol/L(4.08μg/dl),敏感性为78.4%,特异性为79.5%,阳性预测值79.3%,阴性预测值78.6%。F_(0:00am)/F_(8:00am)的曲线下面积为0.807(95%CI 0.751~0.862,SE=0.029),最佳切点为0.3,敏感性为76.1%,特异性为78.3%,Youden指数为0.544,阳性预测值为77.8%,阴性预测值为75.9%。ACTH_(8:00am)的曲线下面积为0.833(95%CI 0.781~0.885,SE=0.027),最佳切点为3.0pmol/L,敏感性为79.5%,特异性为72.7%,Youden指数为0.522,准确率为76.1%,阳性预测值为74.4%,阴性预测值为78.0%。结论在我院实验室条件下,ACTH-皮质醇节律各指标中,午夜血清皮质醇诊断价值最高,最佳切点为113.35nmol/L(4.08μg/dl)。

小剂量米非司酮治疗复发性子宫内膜异位症的疗效评价及卵巢功能和血皮质醇水平的变化

目的:探讨小剂量米非司酮治疗保守性手术后子宫内膜异位症复发的临床疗效、对卵巢功能及血皮质醇的影响。方法:选择经开腹或腹腔镜确诊的子宫内膜异位症复发患者126例,双盲随机分为米非司酮组(n=72)和达那唑组(n=54)。两组分别口服米非司酮和达那唑,治疗3个月后观察治疗前后症状、体征、卵巢功能及血皮质醇的变化。结果:两组间治疗后痛经、非经期下腹痛、性交痛、盆腔触痛、后陷凹结节、子宫活动受限、卵巢异位囊肿体积改善率比较差异均无显著性(P>0.05)。米非司酮组及达那唑组治疗后血清雌二醇(E2)值分别为(74.18±22.32)pmol·L-1和(24.96±3.94)pmol·L-1,两者比较差异有显著性(P<0.01)。米非司酮组及达那唑组停药后恢复月经平均日数分别为(27.0±8.9)d和(40.0±12.4)d,两组比较差异有显著性(P<0.01)。两组治疗前后血清皮质醇值比较差异无显著性(P>0.05)。结论:米非司酮组与达那唑组均能有效改善患者的症状及体征;米非司酮组血清E2保持在卵泡期水平,达那唑组血清E2处于绝经后水平,米非司酮组不出现雌激素缺乏症;停药后米非司酮组较达那唑组排卵功能恢复快,月经复潮时间短,有利于早日受孕;米非司酮与达那唑短期治疗对血清皮质醇均无明显影响。

耐力训练对力竭运动诱导的大鼠淋巴细胞凋亡的影响

目的 :研究耐力训练对大鼠力竭运动后淋巴细胞凋亡的影响 ,并分析其机制。方法 :将SD大鼠随机分为安静组、力竭运动组、训练 +力竭运动组。训练 +力竭运动组进行 3周游泳耐力训练后 ,除安静组外 ,全部大鼠负重 4 %进行力竭游泳 ,比较运动后即刻大鼠脾细胞、胸腺细胞及外周血液淋巴细胞凋亡率 ,细胞内Ca2 +浓度及血清皮质醇 (C)浓度。结果 :训练 +力竭运动组大鼠力竭游泳时间明显长于力竭运动组 (P <0 . 0 5 ) ;训练 +力竭运动组大鼠外周血淋巴细胞凋亡率较安静组有升高趋势 ,但较力竭运动组有下降趋势 ,脾细胞凋亡率与力竭运动组相近 ,胸腺细胞凋亡率显著高于安静组和力竭运动组 (P <0 . 0 5 ) ;训练 +力竭运动组脾细胞、外周血淋巴细胞内Ca2 +浓度及血清皮质醇浓度显著高于安静组 (P <0 . 0 5 ) ;力竭运动组血清皮质醇浓度亦显著高于安静组。结论 :耐力训练对力竭运动所诱导的血淋巴细胞凋亡有一定的抑制作用 ,对脾细胞凋亡无明显影响 ,还有增加胸腺细胞凋亡率的作用。耐力训练对力竭运动所诱导的血淋巴细胞及脾细胞凋亡的影响可能与阻断了细胞内Ca2 +浓度及血清C水平升高所介导的细胞凋亡信号转导有关。

针刺“足三里”对脾虚证大鼠血清中胃泌素、皮质醇含量的影响

目的:探讨针刺“足三里”治疗大鼠脾虚证的作用机理。方法:选用成年雄性Wistar大鼠26只,随机分为4组。其中正常对照组6只,脾虚造模组8只,自然恢复组6只,针刺治疗组6只。除正常对照组外,其余3组均按“彭式”方法建立脾虚证模型。针刺“足三里”治疗11d后,断头取血,用放射免疫方法测定血清中胃泌素(Gas)、皮质醇(Cor)的含量。结果:针刺“足三里”穴可使脾虚大鼠血清中Gas、Cor的水平升高,明显高于模型对照组(P<0.05);自然恢复组与模型对照组比较血清中Gas、Cor含量没有明显变化(P>0.05);自然恢复组血清中Gas、Cor含量明显低于正常对照组和针刺治疗组(P<0.05)。结论:针刺“足三里”治疗脾虚证与其对Gas、Cor等激素水平的调节作用有关。

职业紧张对皮质醇分泌的影响研究

[目的]探讨职业紧张对皮质醇分泌的影响。[方法]采用横断面研究方法对93名男性铁路货运调度员进行研究 ,使用问卷法测试职业紧张因素、个性特征和心理性紧张反应评分 ,采用放射免疫法分析血清和唾液中皮质醇浓度。[结果]相关分析结果显示年龄、婚姻状态和文化程度与血清和唾液中皮质醇浓度的相关系数无显著性意义 ,参与机会评分与唾液皮质醇浓度呈显著性负相关 ,r= -0.6 ,P<0.05;竞争性评分与唾液中皮质醇浓度呈显著性正相关 (P<0.05);血清皮质醇浓度与工作负荷和工作满意感评分呈显著性正相关 (P<0.05)。方差分析结果表明不同工作关系、参与机会、竞争性评分和焦虑特性评分水平唾液中皮质醇浓度差异具有显著性意义 (P<0.05) ,不同工作满意感评分水平血清中皮质醇浓度差异具有显著性意义 (P<0.05)。逐步回归分析结果显示工作前景的未知性、参与机会和竞争性评分分别是血清或唾液中皮质醇浓度的预测因子。

纳甲法针刺对AA大鼠血清皮质醇含量的影响

目的:探讨纳甲法针刺对类风湿性关节炎大鼠的治疗作用和机理。方法:以完全弗氏佐剂关节局部注射造成大鼠类风湿关节炎模型(AA),随机分为正常对照组、模型组、纳甲法针刺组,分别处理后测定各组血清皮质醇、大鼠关节肿以及病理改变。经统计学处理,比较组间差异。结果:模型组大鼠血清皮质醇含量较正常组显著降低(P<0.05),治疗后纳甲法针刺组血清皮质醇升高,同模型组比较差异显著(P<0.05),而与正常组对比无差异(P>0.05)。治疗后纳甲法针刺组大鼠关节肿胀度和病理改变亦较模型组显著降低(P<0.05)。结论:纳甲法针刺对其关节肿胀情况和病理方面有明显改善且可能与调节血清皮质醇含量有关,其针刺的作用机理可能与生物节律等时间因素有关。

针刺复合静脉麻醉用于甲状腺良性结节消融术的临床观察

目的:评价针刺复合静脉麻醉用于甲状腺良性结节微波消融手术的临床效果。方法:选取2016年10月至2018年2月在上海中医药大学附属市中医医院接受甲状腺良性结节微波消融手术的患者66例,随机分为观察组和对照组,每组33例,观察组采用针刺复合静脉麻醉,对照组采用常规静脉麻醉的方法,观察2组镇痛镇静效果、静脉麻醉药的用量、术中打鼾和呼吸抑制发生率以及麻醉前、术毕、术后第1天血清皮质醇(Cor)含量的变化。结果:2组均取得了良好的镇痛和镇静效果;在观察组不用异丙酚的情况下,右美托咪定和芬太尼的用量与对照组比较,差异无统计学意义(P>0.05);观察组术中打鼾和呼吸抑制发生率明显低于对照组;血清Cor含量的变化组间比较,差异无统计学意义(P>0.05),组内比较,2组麻醉前和术毕血清Cor含量差异均无统计学意义(P>0.05),术后第1天早上血清Cor含量较麻醉前和术毕均明显下降,差异有统计学意义(P<0.05)。结论:针刺复合静脉麻醉用于甲状腺良性结节微波消融手术镇痛镇静效果良好,能够减少静脉麻醉药用量;降低术中打鼾和呼吸抑制的发生率,并可以降低术后应激反应。

依托咪酯静脉麻醉对老年腹部手术患者血浆皮质醇及术后认知功能障碍的影响

目的探讨依托咪酯静脉麻醉对老年患者血浆皮质醇浓度及术后认知功能障碍的影响。方法拟行全身麻醉的老年择期腹部手术患者60例,其中男35例,女25例,年龄60～80岁,ASA分级Ⅰ～Ⅲ级。随机分为依托咪酯组(E组)和异丙酚组(P组),每组各30例。麻醉诱导为咪达唑仑0.05 mg/kg、依托咪酯脂肪乳0.3mg/kg(E组)或异丙酚1.5 mg/kg(P组)、芬太尼30μg/kg、阿曲库铵0.6 mg/kg。麻醉维持以阿曲库铵(靶浓度2.0～2.5μg/mL)泵注,另E组以依托咪酯(靶浓度1.0～1.3μg/mL)泵注,P组以异丙酚(靶浓度3～4μg/mL)泵注,术中间断静注芬太尼。维持脑电双频指数(BIS)值40～60。放射免疫法检测麻醉前5 min、插管后5 min、手术结束时、术后24 h、术后48 h血浆皮质醇浓度。用简易智能状态(MMSE)法检查患者手术前1天、术后第1、3、5、7天的认知功能,并统计分值。结果与麻醉前相比,两组手术结束时及E组术后24 h的血浆皮质醇浓度均明显降低(P<0.05)。与P组相比,E组手术结束时血浆皮质醇浓度明显降低(P<0.05),两组术后48 h皮质醇浓度均恢复正常。MMSE评分比较,两组间各时间点差异均无统计学意义(P>0.05),但两组术后第1、3天MMSE评分与术前1天比较差异有统计学意义(P<0.05)。结论依托咪酯可用于老年择期腹部手术患者全凭静脉麻醉,其抑制肾上腺皮质功能是短暂的、可逆的,并且不增加术后认知功能障碍的发生率。

圈养雄性麋鹿血清睾酮和皮质醇含量在发情期的变化

20 0 0年 7～ 8月在北京麋鹿苑采集不同繁殖状态雄鹿 (发情前 3头、发情 3头和发情后 4头 )血液样品 ,用放射免疫分析法测定血清睾酮和皮质醇含量。结果显示发情雄鹿的睾酮浓度显著高于发情前、后 ,而3种状态雄鹿的皮质醇浓度无差异 ,并且与睾酮浓度无关。

慢性心理应激对大鼠行为及血清皮质醇影响及运动的调节作用

目的了解慢性心理应激对大鼠行为和血清皮质醇的影响,探讨适宜运动对慢性心理应激的调节作用。方法采用慢性束缚心理应激模型,将60只成年雄性Sprague-Dawley(SD)大鼠随机均分为正常对照组、应激模型组、30 min运动组、60 min运动组、应激+30 min运动组及应激+60 min运动组,通过对大鼠的行为观察、悬尾试验及旷场活动试验的测定,动态观察各组大鼠在应激及运动调节前后的行为学方面的变化;采用放射免疫学方法测定大鼠应激及运动调节前后血清中皮质醇浓度的改变。结果应激模型组的血清皮质醇浓度最高,与正常对照组比较,差异有统计学意义(P<0.05)。应激+30 min运动组及应激+60 min运动组的血清皮质醇浓度均低于应激模型组(P<0.05),而与正常对照组及运动对照组比较,差异无统计学意义(P>0.05);旷场实验结果显示,应激模型组的中央格停留时间最长,穿格次数、直立次数及修饰时间最少,与正常对照组、应激+30 min运动组及应激+60 min运动组比较,差异有统计学意义(P<0.05);悬尾实验结果显示,慢性心理应激模型组的静止时间较长、挣扎次数较少,与正常对照组大鼠比较,差异有统计学意义(P<0.05)。结论适宜运动调节能够有效抵抗机体皮质醇的过量释放,减缓心理及行为的应激水平。

新风胶囊对类风湿关节炎患者抑郁情绪及血清皮质醇的影响

目的观察新风胶囊对类风湿关节炎(RA)患者抑郁情绪及血清皮质醇的影响,并探讨其作用机制。方法76例RA患者随机分成2组,治疗组40例采用新风胶囊,对照组36例采用正清风痛宁缓释片,观察2组的临床疗效、主要症状体征、生活质量积分、抑郁自评量表(SDS)标准分及血清皮质醇等指标变化。结果新风胶囊治疗组在总有效率、改善症状体征、活动性指标等方面与对照组相似,但在改善SDS标准分、脾虚症状、生活质量积分方面明显优于正清风痛宁对照组(P<0.05或P<0.01)。结论新风胶囊在取得疗效的同时,可改善RA患者抑郁情绪,提示新风胶囊调节内分泌失调、提高机体免疫功能及改善贫血是其可能性机制。