本文選題：糖尿病　切入點(diǎn)：P物質(zhì)　出處：《山西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過測(cè)定行不同類型手術(shù)的糖尿病患者與非糖尿病患者圍術(shù)期血漿P物質(zhì)(Substance P,SP)、降鈣素基因相關(guān)肽(Calcitonin gene-related peptide,CGRP)、肌鈣蛋白I(Cardiac troponin I,cTnI)的變化,探討糖尿病患者體內(nèi)SP、CGRP改變與其圍術(shù)期心肌損傷的相關(guān)性。方法:55例擇期行腹腔鏡下膽囊切除術(shù)(Laparoscopic cholecystectomy,LC)、61例擇期行腰椎后路減壓植骨融合內(nèi)固定術(shù)(Posterior lumbar interbody fusion,PLIF)的患者按是否患有糖尿病(diabetes mellitus,DM)分為糖尿病組(DM)和非糖尿病組(NDM)。觀察并記錄術(shù)中血壓、心率、心律、ST-T段、脈搏血氧飽和度、手術(shù)時(shí)間、輸液量及出血量;測(cè)定患者術(shù)前、術(shù)畢血糖值;選用酶聯(lián)免疫法測(cè)定患者血漿術(shù)前、術(shù)畢SP、CGRP、去甲腎上腺素(norepinephrine,NE)的含量以及術(shù)前、術(shù)后24小時(shí)血漿cTnI的含量。結(jié)果:按照術(shù)中有無發(fā)生不良心血管事件(Adverse Cardiovascular Event,ACVE)分類,發(fā)生ACVE者術(shù)前、術(shù)畢24小時(shí)血漿cTnI含量(3.82±0.60ng/mL,6.24±1.01ng/m L)較未發(fā)生者(3.46±0.31ng/mL,5.99±0.91ng/mL)高(P0.05),且其術(shù)前、術(shù)畢血漿CGRP濃度(61.37±11.45ng/mL,61.91±11.52ng/mL)、SP濃度(3.19±0.48ng/mL,2.96±0.43ng/mL)較未發(fā)生者(64.21±14.01ng/mL,64.55±14.06ng/mL)、(3.53±0.70ng/mL,3.37±0.63ng/mL)低(P0.05);DM組術(shù)中ACVE發(fā)生率(52%)較NDM(43%)高(P0.05),術(shù)前、術(shù)畢CGRP含量DM組(58.00±15.90ng/mL,57.93±16.00ng/mL)較NDM組(66.89±7.54ng/mL,67.32±7.08ng/mL)低(P0.05);術(shù)前、術(shù)畢SP含量DM組(3.13±0.41ng/mL,2.98±0.45ng/mL)較NDM組(3.58±0.70ng/mL,3.33±0.65ng/mL)低(P0.05)且DM組術(shù)前、術(shù)畢24小時(shí)cTnI含量(4.88±0.94ng/mL,5.64±1.16ng/mL)較NDM(4.18±0.53ng/mL,4.19±1.73ng/m L)組高(P0.05)。DM、NDM組術(shù)前術(shù)畢CGRP濃度無顯著變化(P0.05),DM、NDM組術(shù)畢SP濃度較術(shù)前降低(P0.05),但NDM組行腰椎后路減壓融合術(shù)患者術(shù)畢SP、CGRP的變化(0.91±0.23ng/mL;0.84±0.16ng/mL)較行LC的患者(0.11±0.09ng/mL;0.19±0.11ng/mL)大(P0.05ng/mL),DM組未看到這種改變。結(jié)論:本研究結(jié)果提示糖尿病患者血漿SP、CGRP降低與其圍術(shù)期心肌損傷有關(guān)。
[Abstract]:Objective: through the peri operation period of diabetic patients with plasma P substance determination for different types of surgery and non diabetic patients (Substance P, SP), calcitonin gene related peptide (Calcitonin gene-related peptide CGRP I (Cardiac troponin), troponin I, cTnI) to investigate the changes of SP in diabetic patients, CGRP change and Wai correlation of perioperative myocardial injury. Methods: 55 cases of patients undergoing laparoscopic cholecystectomy (Laparoscopic cholecystectomy, LC), 61 cases of patients undergoing posterior lumbar interbody fusion surgery (Posterior lumbar interbody fusion, PLIF) of the patients according to whether suffering from diabetes (diabetes mellitus, DM) were divided into diabetic group (DM) and non diabetes group (NDM). Observe and record the intraoperative blood pressure, heart rate, heart rate, ST-T, SpO2, operative time, transfusion volume and blood; Determination of patients before operation, postoperative blood glucose; using ELISA 娉曟祴瀹氭?zhèn)ｈ�呰嫻嗘湳鍓，

本文編號(hào)：1646048