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处于应激状态患者体内环磷酸腺苷/环磷酸鸟苷的动态变化

Dynamics of cAMP/cGMP in patients under a stress state.

作者信息

Chen Peng, Chai Ying

机构信息

The Second Affiliated Hospital, Medical School, Zhejiang University, Hangzhou 31 0009, China.

出版信息

Chin J Traumatol. 2002 Apr;5(2):115-7.

Abstract

OBJECTIVE

To investigate the dynamics of plasma cAMP/cGMP in patients during cardiac surgery, and its relationship to traumatic stress.

METHODS

Sixteen patients, aged 19.31 years+/-10.4 years, who underwent an open heart operation with cardiopulmonary bypass (CPB) and hypothermia were served as subjects. The arterial plasma concentrations of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) were measured by radioimmunoassay 2 hours before operation, after heparinization, 20 minutes following CPB, at the end of the operation, and 24 and 72 hours postoperatively, respectively. The patients' preoperative blood samples were heparinized and the venous blood samples of 30 healthy blood donors were taken to measure the levels of cAMP and cGMP as heparin and normal controls separately.

RESULTS

There were no statistical difference among the heparin control, preoperative level and normal control. The peak values of cAMP and cGMP occurred during CPB and plasma cAMP levels changed synchronously with intensities of operative stimulus to human body. However cGMP level was mainly related to the operative stimulus to the heart and CPB. The cAMP value was positively correlated with the cGMP value (r=0.6313, P<0.001).

CONCLUSIONS

Dynamic variation of plasma cyclic ribonucleotide can be considered as a reference parameter for intensity of traumatic stress.

摘要

目的

探讨心脏手术患者血浆环磷酸腺苷(cAMP)/环磷酸鸟苷(cGMP)的动态变化及其与创伤应激的关系。

方法

选取16例年龄为19.31岁±10.4岁、行体外循环(CPB)和低温下心内直视手术的患者作为研究对象。分别于术前2小时、肝素化后、CPB后20分钟、手术结束时及术后24小时和72小时,采用放射免疫分析法测定动脉血浆中环磷酸腺苷(cAMP)和环磷酸鸟苷(cGMP)的浓度。将患者术前肝素化的血样及30名健康献血者的静脉血样分别作为肝素对照和正常对照,测定cAMP和cGMP水平。

结果

肝素对照、术前水平与正常对照之间无统计学差异。cAMP和cGMP的峰值出现在CPB期间,血浆cAMP水平与手术对人体刺激的强度同步变化。然而,cGMP水平主要与手术对心脏和CPB的刺激有关。cAMP值与cGMP值呈正相关(r = 0.6313,P < 0.001)。

结论

血浆环核苷酸的动态变化可作为创伤应激强度的参考指标。

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