电针内关联合右美托咪啶对高血糖冠心病患者围术期心肌损伤的疗效观察

陈轶菁, 沈华, 宗蕾, 金河廷

陈轶菁, 沈华, 宗蕾, 金河廷. 电针内关联合右美托咪啶对高血糖冠心病患者围术期心肌损伤的疗效观察[J]. 实用临床医药杂志, 2013, (11): 18-21. DOI: 10.7619/jcmp.201311006
引用本文: 陈轶菁, 沈华, 宗蕾, 金河廷. 电针内关联合右美托咪啶对高血糖冠心病患者围术期心肌损伤的疗效观察[J]. 实用临床医药杂志, 2013, (11): 18-21. DOI: 10.7619/jcmp.201311006
CHEN Yijing, SHEN Hua, ZONG Lei, JIN Heyan. Efficacy of electro-acupuncture on Neiguan combined with dexmedetomidine to myocardial injury of high blood sugar patients with coronary heart disease in perioperative period[J]. Journal of Clinical Medicine in Practice, 2013, (11): 18-21. DOI: 10.7619/jcmp.201311006
Citation: CHEN Yijing, SHEN Hua, ZONG Lei, JIN Heyan. Efficacy of electro-acupuncture on Neiguan combined with dexmedetomidine to myocardial injury of high blood sugar patients with coronary heart disease in perioperative period[J]. Journal of Clinical Medicine in Practice, 2013, (11): 18-21. DOI: 10.7619/jcmp.201311006

电针内关联合右美托咪啶对高血糖冠心病患者围术期心肌损伤的疗效观察

详细信息
  • 中图分类号: R541.4

Efficacy of electro-acupuncture on Neiguan combined with dexmedetomidine to myocardial injury of high blood sugar patients with coronary heart disease in perioperative period

  • 摘要: 目的 探讨电针内关联合右美托咪啶对高血糖冠心病患者非心脏手术心肌损伤的影响.方法 选取择期行下肢骨科手术患者60例,并将患者随机均分为D组(右美托咪定)、C组(电针)和N组(电针内关联合右美托咪啶).3组患者分别于插管前(T0)、插管后即刻(T1)、插管后5 min(T2)、拔管后即刻(T3)、拔管后5 min(T4)、拔管后60 min(T5)、拔管后180min(T6)测定血糖、血浆TXB2和6-keto-PGF1a浓度,计算血糖变异系数(GluCV)和TXB2/6-keto-PGF1a的比值;记录ST段高度变化及HR、MBP的改变.结果 插管和拔管前后3组TXB2和6-keto-PGF1α均显著升高(P<0.05);N组TXB2明显低于D、C组(P<0.05),6-keto-PGF1α明显高于D、C组(P<0.05);D、C组TXB2/6-keto-PGF1α显著升高,且明显高于N组(P<0.05).N组T1~T4时HR、MAP、ΣST明显低于D、C组(P<0.05),且N组GluAve、GluSD、GluCV变化明显低于D、C组(P<0.05).结论 内关穴的双向调节作用可能加强α2肾上腺素能受体激动剂右美托咪定的作用并减轻其不良反应,抑制手术应激所致的血糖波动和TXA2/PGl2失衡,改善心肌缺血损伤.
  • Bhadriraju S, Ray K K, DeFranco A C. Association between blood glucose and long-term mortality in patients with acute coronary syndromes in the OPUS TIMI 16 trial [J]. American Journal of Cardiology, 2006, (11):1573.
    Donald R A, Crozier I G, Foy S G. Plasma corticotrophin releasing hormone, vasopressin, ACTH and cortisol responses to acute myocardial infarction [J]. Clinical Endocrinology(Oxford), 1994(4):499.
    沈华, 陈轶菁. 右美托咪啶对高血糖冠心病患者围术期血糖变异性及血栓素A2和前列环素平衡的影响 [J]. 临床麻醉学杂志, 2012(4):375.
    中国心脏调查组. 中国住院冠心病患者糖代谢异常研究-中国心脏调查 [J]. 中华内分泌代谢杂志, 2006, (1):7.doi: 10.3760/j.issn:1000-6699.2006.01.003.
    王敬, 谭志明. 围术期应激性高血糖的研究进展 [J]. 国际麻醉学与复苏杂志, 2012(3):199.doi: 10.3760/cma.j.issn.1673-4378.2012.03.013.
    Azarfarin R, Alizade Asl A. Prevalence and intensity of hyperglycemia in non-diabetic patients undergoing coronary artery bypass graft surgery with and without cardiopulmonary bypass [J]. Saudi Medical Journal, 2008(9):1294.
    Monnier L, Mas E, Ginet C. Activation of oxidative stress by acute glucose nuctuationscompared with sustained chronic hyperglycemia in patients with type 2 diabetes [J]. Journal of the American Medical Association, 2006.1681.
    Hunu R, Heinen A, Weber N C. Hyperglycaemia blocks sevofluraneinduced postconditioning in the rat heart in vivo:cardioprotection can be restored by blocking the mitochondrial permeability transition pore [J]. British Journal of Anaesthesia, 2008(4):465.
    穆东亮, 敖虎山. 非体外循环冠状动脉旁路移植术患者术中血糖波动水平与短期预后的关系 [J]. 中华麻醉学杂志, 2011(2):141.doi: 10.3760/cma.j.issn.0254-1416.2011.02.001.
    Gotoh S, Ogihara T, Nakamaru M. Levels of plasma.6-keto-PGFla in normotensive and essential hypertensive males with and without a family history of hypertension [J]. Prostaglandins Leukotr Med, 1983(1):27.
    刘俊岭, 陈淑萍, 曹庆淑. 延髓腹外侧区微量注射可乐宁、育亨宾对电针治疗心肌缺血效应的影响 [J]. 针刺研究, 1996(2):31.
    岳进, 徐珊珊, 马玲. 针刺内关穴对窦房结功能的影响 [J]. 中国针灸, 2008(9):639.
计量
  • 文章访问数:  142
  • HTML全文浏览量:  26
  • PDF下载量:  8
  • 被引次数: 0
出版历程
  • 发布日期:  2013-10-14

目录

    /

    返回文章
    返回
    x 关闭 永久关闭