心血管应激和芬太尼对血浆心钠素水平的影响

本实验探讨全麻气管插管心血管应激及芬太尼作用对血浆心纳素水平的影响。结果显示，实验组气管插管心血管应激反应明显，血浆心钠素水平伴随升高，且与血压心率的增加呈高度正相关关系。而对照组在给予６μ８·ｋｇ（－１）芬太尼抑制气管插管应激反应时，插管期间循环兴奋性明显减弱，血浆心钠素水平亦未见升高。因此说明：①血浆心钠素水平与气管插管心血管应激程度密切相关，是气管插管应激指标之一；②芬太尼不参与人类血浆心钠素水平的调节。

EFFECTS OF CARDIOVASCULAR STRESS AND FENTANYL ON PLASMA ATRIAL NATRIURETIC PEPTIDE LEVELS

This study was designed to investigate the effects of cardiovascular stress of endotracheal intubation and fentanyl on plasma ANP levels. Twenty-two patients,scheduled for noncardiac surgery, were randomly assigned to receive either saline solution (test group, n=11) or 6 ug/kg of fentanyl by iv drip (control group, n=11) before tracheal intubation, induction of anesthesia was accomplished with 4mg/kg of thiopental and 1. 5mg/kg of succinylcholine iv. After intubation , 4mgimbretil was given by iv bolus immediately. No other drug was administered until 5 minutes after intubation. The amount of intravenous saline infusion during induction period for each case was limited to 2 ml/kg.Test group patients had higher SBP, DBP, HR during the first 3 minutes after intubation than patients given fentanyl (p<0. 05); plasma concentrations of ANP increased significantly in test group patients, but not in controlsat the moment of intubation (p<0. 05). Increase of plasma ANP concentration correlated positively with the increase in MAP and HR (rMAP=0. 76, p<0. 05; rHR=0. 82, P< 05). We conclude that 1) ANP may be used as one of the indices of the stress responses of endotracheal intubation, 2) fentanyl has no effect on plasma ANP concentration during tracheal intubation.