观察血清应激指标变化探讨建立新的PTCA专业护理模式

目的:探讨经皮冠状动脉成形术(PTCA)前后冠心病患者血清应激指标水平变化以探讨建立新的PTCA专业护理模式。方法:将研究对象设置为健康人组45例、非手术组46例和手术组50例。血清皮质醇(Cor)、垂体泌乳素(PRL)、促甲状腺激素(TSH)和超氧化物歧化酶(SOD)均采用RIA法;过氧化脂质(LPO)和谷胱甘肽过氧化物酶(GPX)测定分别采用自动生化分析法。结果:(1)应激性激素变化,非手术组患者Cor和TSH水平显著高于健康人组(P<0.01),PRL水平略有升高,但统计差异不显著(P>0.05);手术组术前三项激素水平均显著高于健康人组和非手术组(P<0.01);手术组术后三项激素水平均显著高于健康人组、非手术组及手术组术前(P<0.01)。(2)氧化应激指标变化,非手术组及手术组术前SOD和GPX两项抗氧化酶水平均显著低于健康人组(P<0.01),LPO水平显著高于健康人组(P<0.01);手术组术后SOD和GPX水平明显回升均高于非手术组和手术组术前(P<0.01),但仍明显低于健康人组(P<0.01),LPO水平也明显恢复几近健康人组水平(P<0.01),但低于非手术组及手术组术前(P<0.01)。结论:本文指标的测定为患者应激的存在提供了重要的实验室依据,对于建立新的PTCA专业护理模式有重要临床意义。

Study on the clinical significance of changes of serum stress parameters in patients with coronary heart disease to discuss establishment the new mode of nursing on cardiac interventional therapy

Objective ：To investigate the changes of serum stress parameters levels for discuss establishment the new mode of nursing on cardiac interventional therapy. Methods：The serum levels of Cor,PRL,SOD and TSH were determined with radioimmunoassay and serum LPO and GPX levels were determined with biochemistry both before and after PTCA operation in 50 patients with coronary heart disease as well as in 46 non - operation patients and 45 controls. Results ： The serum levels of Cor were significant higher in non - operation patients group than those in the controls （ P 〈 0.01 ）, the serum levels of PRL and TSH were not significant higher in non - operation patients group than those in the controls （ P 〉 0.05 ）. The serum levels of Cor, PRL and TSH were signifi- cant higher in the before operation patients group than those in the non - operation patients group （P 〈 0.01 ）, after operation patients group, serum levels of Cor, Pill and TSH were significant higher than those in the before operation patients group（ P 〈 0.01 ）. The serum levels of SOD, LPO L and GPX were significant higher（ or significant lower）in the non -operation patients group than those in the controls（ P 〈 0.01 ） ,the serum levels of SOD, LPO L and GPX were significant higher in the before operation patients group than those in the non - operation patients group （P 〈 0.01 ）, after operation patients group serum levels of SOD were significant higher than those in th before operation patients group（ P 〈 0.01 ）, the serum levels of LPO and GPX were all no significant difference in the after operation patients group than those in th before operation patients group （ P 〈 0.01 ）. Conclusion ： Determination of serum stress parameters levels of patients with coronary heart disease on cardiac interventional therapy possess clinical significance for discuss establishment the new mode of nursing on cardiac interventional therapy.