糖尿病患者P物质含量与围手术期不良心血管事件的相关性研究

目的 探讨糖尿病患者血清P物质(substance P,SP)含量变化与围手术期不良心血管事件(adverse cardiovascular event,ACVE)的相关性. 方法 择期行胆囊切除术的患者44例,根据术前有无糖尿病分为两组(每组22例):糖尿病组(DM组)与对照组(C组).记录两组患者术前一般情况(年龄、性别、ASA分级、体重、血脂、肌酐等),术中血糖、心律、HR、BP、ECG、手术时间以及补液量等变化.采用ELISA法测定术前、术毕SP含量以及术前、术后24 h肌钙蛋白Ⅰ(cardiac troponin Ⅰ,cTnⅠ)含量. 结果 DM组患者胆囊切除术围手术期ACVE发生率(68.18％)较C组(36.36％)高(P＜0.05);DM组患者术前、术毕血清SP含量[(1.1 ±0.4)、(1.0±0.5) μg/L]较C组[(1.6±o.7)、(1.3±o.6)ug/L]低(P＜0.05),而术前、术后24 h血清cTnⅠ含量[(1.8±0.6)、(2.4±1.0)μg/L]较C组[(1.2±0.5)、(1.4±0.6)μg/L]高(P＜0.05);根据围手术期有无发生ACVE进行分类,发生ACVE患者SP含量[(1.0±0.5)μg/L]较未发生ACVE患者(non-ACVE,NACVE)SP含量[(1.4±0.7)μg/L]低(P＜0.05).结论 糖尿病患者血清SP含量降低可能与患者围手术期ACVE的发生率有关.

Correlative study on the substance P contents with perioperative adverse cardiovascular events in diabetic patients

Objective The aim of the study was to investigate the association of reduction of serum substance P (SP) with increase in perioperative adverse cardiovascular events (ACVE) in diabetic patients.Methods Forty-four patients who underwent cholecystectomy were divided into control group (group C) and diabetes mellitus group (group DM)(n=22).The general characteristics,including age,gender,ASA grade,body weight,serum lipids,serum creatinine before the operation were analyzed.During the operation,heart rhythm,HR,ST-segment BP and ECG were monitored and the blood glucose,the volume of bleeding and the intravenous infusion were recorded.The content of serum SP (at pre-operation and the end-operation) and cardiac troponin Ⅰ (cTnⅠ),at pre-operation and at 24 h after-operation were examined by ELISA.Results The incidence of adverse cardiovascular events in the diabetic patients was significantly higher (68.18％) during the surgery,compared with that of the patients in control group (36.36％)(P＜ 0.05).In the meantime,SP at pre-operation and the end-operation being (1.1 ±0.4) μg/L and (1.0±0.5) μg/L,respectively,were significantly lower than that in the control group of the time,(1.6±0.7) μg/L and (1.3±0.6) μg/L,respectively (P＜0.05).And higher serum cTnⅠ at pre-operation and 24 h after-operation (1.8±0.6) μg/L and (2.4±1.0) μg/L,respectively,in the diabetic patients were observed,compared with that in the patients of control group of the time (1.2±0.5) μg/L and (1.4±0.6) μg/L,respectively(P＜0.05).The analysis presented that the patients without adverse cardiovascular event(NACVE) had the serum SP,as (1.4±0.7) μg/L,significantly higher than the serum SP (1.0±0.5) μg/L of the patients with intra-operative adverse cardiovascular event (P＜0.05).Conclusions The results of this study indicates the reduction in serum SP may be associated with increase in the perioperative adverse cardiovascular events in diabetic patients.