不同麻醉方法对老年高血压患者下肢关节置换术中高敏C反应蛋白的影响

目的探讨老年高血压患者在下肢关节置换术中，不同麻醉方法对血清高敏c反应蛋白（highsen—sitivity C．reactivityprotein，hs—CRP）的影响。方法根据病人体质状况和美国麻醉师协会（ASA）对手术危险性进行分类，选择Ⅱ～Ⅲ级择期下肢关节置换手术患者30例，随机分为2组，全身麻醉组（A组）和蛛网膜下腔阻滞组（B组），每组15例。检测2组患者麻醉前（T0）、麻醉后5min（T1）、手术1h（T2）、手术结束缝皮时（T3）的血清hs—CRP水平。结果（1）与麻醉前比较，A、B组不同时点的hs—CRP水平差异均无统计学意义。（2）B组在T2时点hs—CRP显著高于A组（P〈0．05）；其余时点无明显差异。结论2种麻醉方法均可显著降低心肌耗氧量，有效改善心肌氧供需平衡，2组患者心血管事件发生危险性均无明显增加。

Influence of different anesthetic methods on sercem high sensitivity C-reactive protein in aged hypertensive patients undergoing joint replacement for lower extremity

Objective To investigate the influence of different anesthetic methods on sercem high sensitivity C-reactive protein（hs-CRP） in aged hypertensive patients undergoing joint replacement for lower extremity Methods Thirty consecutive aged patients （ ASA Ⅱ -Ⅲ ） with hypertension undergoing scheduled total knee or hip replacement were enrolled in this study. The patients were randomly divided into general anesthesia group （group A） and subarachnoid block group （ group B）. The hemodynamics were monitored continuously during operation, and the scram level of hs-CRP was examined before anesthesia induction（T0） , 5 min（ T1 ）after anesthesia induction, 1 h （T2）after surgical incision, and at the end of operation（T3）. Results （ 1 ） Compared to TO, the concentrations of hs-CRP at different time points in both groups showed no statistical significance. （2） The concentration of hs-CRP at T2 in group B was significantly higher than that in group A. Conclusions Myocardial oxygen consumption could be decreased by general anesthesia or spinal anesthesia. There is no significant increase in the risk of cardiovascular disease in both groups.