不同剂量羟考酮对腹腔镜胆囊切除术患者血清血栓素A2、血浆内皮素水平和免疫功能的影响

目的:探讨不同剂量羟考酮对腹腔镜胆囊切除术患者血清血栓素A2(TXA2)、血浆内皮素(ET)水平和免疫功能的影响。方法:选择2013年8月至2016年8月我院接诊的90例择期行腹腔镜胆囊切除术患者,以随机数表法分为3组,各30例。于手术开始前,均静脉注射羟考酮,A组剂量0.1 mg/kg、B组剂量0.2 mg/kg、C组剂量0.3 mg/kg。比较三组T0(入室后)、T1(麻醉诱导后)、T2(插管后)、T3(胆囊分离时)、T4(手术结束)时点血流动力学、TXA2、ET的变化以及T0、T5(术后2 h)、T6(术后1 d)、T7(术后3 d)时点免疫功能的变化;并记录拔管时间、苏醒时间、降压药、止痛药的使用情况及不良反应的发生情况。结果:三组在T2、T3时点舒张压(DBP)、收缩压(SBP)、心率(HR)较T0时点比较显著升高(P0.05),B、C组在T2、T3时点DBP、SBP、HR均明显低于A组(P0.05);三组T2、T3、T4时点TXA2较T0时点比较均显著升高,且A组B组C组,两两比较均具有显著差异(P0.05);三组T2、T3时点ET较T0时点均显著升高(P0.05),A组在T2、T3时点ET均明显高于B、C组(P0.05);三组在T5时点CD3~+、CD4~+、CD8~+、CD4~+/CD8~+较T0时点比较均显著降低(P0.05),A组在T5时点CD3~+、CD4~+、CD8~+、CD4~+/CD8~+均明显低于B、C组(P0.05);C组拔管时间明显长于A、B组(P0.05);C组不良反应总发生率明显高于A、B组(P0.05)。结论:在胆囊切除术中,应用0.2 mg/kg羟考酮对血流动力学、TXA2、ET及免疫功能的影响较小,且安全性高。     

Dynamic changes of cardiovascular regulating factors in rats after aerobic exhaustive exercise

Objective To study the changes of cardiovascular regulating factors in rats during recovery of aerobic exhaustive exercise. Methods Sixty male Wistar rats were randomly divided into control group, 1 h-exercise group, 3 h-exercise group, exhausted group, 2 h-recovery group and 12 h-recovery group. The rats were killed at corresponding times for each group after an 8-week-long treadmill training, and the levels of NO, El-, ANP and TXB2 in plasma were measured in each group. Results NO/ET ratio of 1 h-exercise group was significantly higher than that in control group （P〈0.01）, while it was significantly decreased in 3 h-exercise group and exhausted group （P〈0.05）. ANP contents in rat plasma were significantly higher in 3 h-exercise group, exhausted group and 2 h-recovery group than that in control group （P〈0.05 or P〈0.01）. The concentration of TXB2 in plasma was significantly increased in 3 h-exercise group, exhausted group and 2 h-recovery group （P〈0.05）. Conclusion Changes in cardiovascular regulating factors after exhaustive exercise may lead to deficiency of coronary circulation blood/oxygen supply, which may cause exercise- induced fatigue.     

山羊减压病时血液血栓素B_2及6—酮—前列腺素F_(1α)的变化

本文报告了山羊急性减压病时血液TXB_2和6—Keto—PGF_(1α)的动态变化,22只山羊被分为两组,其中12只为实验组并被造成急性实验性减压病模型。另外10只为对照组。分别于进加压舱前和出加压舱后5min1h、2h、3h、及24h测定动物心前区Doppler气泡音并采血测血液中TXB_2、6-keto-PGF_(1α)及血小板计数。 实验结果表明,当山羊患急性减压病时,其血液中TXB_2明显升高而6-keto-PGF_(1α)明显降低。也就是说存在着TXA_2与PGI_2的失平衡。鉴于TXA_2与PGI_2平衡对维持血液内环境稳定的重要作用,笔者认为急性减压病时所存在的TXA_2与PGI_2失平衡对于减压病的发生和转归是十分重要的。