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腹部手术期间肠系膜牵引后前列腺素I2的释放由环氧化酶-1介导。

Prostaglandin I2 release following mesenteric traction during abdominal surgery is mediated by cyclooxygenase-1.

作者信息

Bucher Michael, Kees Frieder K, Messmann Barbara, Lunz Dirk, Rath Stephan, Zelenka Marek, Schlitt Hans J, Hobbhahn Jonny

机构信息

Department of Anesthesiology, Regensburg University, 93042 Regensburg, Germany.

出版信息

Eur J Pharmacol. 2006 May 1;536(3):296-300. doi: 10.1016/j.ejphar.2006.03.009. Epub 2006 Mar 13.

Abstract

Our study aimed to determine the role of cyclooxygenase-2 in the release of prostaglandin-(PG)-I2 following mesenteric traction during abdominal surgery. In a prospective double-blind, randomized, placebo-controlled study, 40 patients electively scheduled for non-laparoscopic abdominal surgery, were pretreated with the cyclooxygenase-2 inhibitor parecoxib (n=20) or placebo (n=20). Heart rate, arterial blood pressure, oxygenation ratio and plasma concentrations of the stable PGI2-metabolite 6-keto-PGF1alpha were compared between groups before injection of parecoxib (-40 min), immediately before mesenteric traction (0 min), and 5, 10, and 30 min thereafter. In addition, plasma concentrations of valdecoxib, the active metabolite of the prodrug parecoxib, were determined. Plasma concentrations of 6-keto-PGF1alpha and heart rate increased in both groups after mesenteric traction. There were no significant differences between groups at individual times in heart rate, arterial blood pressure and plasma concentrations of 6-keto-PGF1alpha. Oxygenation ratio decreased after 10 and 30 min following mesenteric traction in the parecoxib group with a significant difference between treatment groups at 10 and 30 min. Plasma concentrations of valdecoxib revealed therapeutic values. Our data indicate that PGI2 release following mesenteric traction is mediated by cyclooxygenase-1.

摘要

我们的研究旨在确定环氧化酶-2在腹部手术中肠系膜牵引后前列腺素(PG)-I2释放中的作用。在一项前瞻性双盲、随机、安慰剂对照研究中,40例择期行非腹腔镜腹部手术的患者,分别接受环氧化酶-2抑制剂帕瑞昔布(n = 20)或安慰剂(n = 20)预处理。比较两组在注射帕瑞昔布前(-40分钟)、肠系膜牵引前即刻(0分钟)以及此后5、10和30分钟时的心率、动脉血压、氧合比和稳定的PGI2代谢产物6-酮-PGF1α的血浆浓度。此外,还测定了前体药物帕瑞昔布的活性代谢产物伐地昔布的血浆浓度。肠系膜牵引后两组的6-酮-PGF1α血浆浓度和心率均升高。两组在各时间点的心率、动脉血压和6-酮-PGF1α血浆浓度均无显著差异。帕瑞昔布组在肠系膜牵引后10分钟和30分钟时氧合比降低,治疗组在10分钟和30分钟时有显著差异。伐地昔布的血浆浓度显示出治疗价值。我们的数据表明,肠系膜牵引后的PGI2释放是由环氧化酶-1介导的。

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