不同溶液术前扩容对冠心病患者围术期ICAM-1、VCAM-1的影响

目的]观察6%羟乙基淀粉(HES)130/0.4溶液和乳酸钠林格 (RL) 液术前扩容对冠心病患者围术期血清内皮细胞间粘附分子-1(ICAM-1)、血管细胞粘附分子-1(VCAM-1)的影响.方法]40例择期行胆囊切除术的冠心病患者随机被分为HES组和RL组,每组20例.另选15例健康体查者为正常对照组(NC组)....

Effect of Preloading Infusion with Different Solutions on ICAM-1 and VCAM-1 in Patients with Coronary Heart Disease During Perioperative Period

Objective] To investigate the effect of preloading infusion（PLI） with 6% hydroxyethyl starch （HES） 130/0.4 or Ringer＇s lactated（RL） solution on intercellular adhesion molecule I（ICAM-1） and vascular cell adhesion molecule 1 （VCAM-1） of patients with coronary heart disease（CHD） during perioperative period. Methods] Forty patients with CHD undergoing choIecystectomy were randomly and equally assigned into HES group and RL group. Fifteen healthy volunteers were selected as normal control group（NC group）. HES or RL solution were respectively infused at a dose of 10mL/kg over a period of 30rain when anesthesia induction began. The levels of ICAM-1 and VCAM-1 in serum were determined by enzyme-linked immunosorbent assay before anesthesia（T0 ）, 30rain after the beginning of operation（T1 ）, 2h（T2 ） and 4h（Ta ） after the end of operation. Results] The levels of ICAM-1 and VCAM-1 in serum were higher in HES group and RL group at baseline time than those in NC group（ P 〈0. 05）. The levels of ICAM-1 and VCAM-1 in serum were increased significantly at T1 , T2 and Ta as compared with baseline values at To in RL group（ P 〈0.05） Compared with RL group, the levels of ICAM-1 and VCAM 1 in serum were decreased significantly in HES group at T1 , T2 and T3 （ P 〈0.05）. Conclusion] 6% HES 130/0.4 can decrease the serum concentration of ICAM- 1 and VCAM-1 of patients with coronary heart disease during perioperative period, which may alleviate inflammation response of coronary atheroselerotic plaque.