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目的探索急性主动脉夹层(acute aortic dissection,AAD)患者是否存在血清儿茶酚胺质量浓度的升高,以及患者血清儿茶酚胺质量浓度与氧合指数(oxygenation index,OI)的关系。方法 2013年4~12月期间,纳入3组患者(A组38例AAD患者、B组28例升主动脉瘤患者、C组22例心绞痛患者)为研究对象,收集所有患者一般临床资料,测定OI并采集血液标本测定肾上腺素(adrenaline,AD)、去甲肾上腺素(noradrenaline,NA)、内毒素(endotoxin,ET)的血清质量浓度。通过对3组患者上述指标的对比分析,观察AAD患者血清儿茶酚胺质量浓度是否升高;采用直线相关分析AAD患者血清儿茶酚胺质量浓度与ET质量浓度以及OI的关系。结果 3组患者一般临床资料差异无统计学意义。A组患者血清AD、NA、ET质量浓度均高于B组和C组(P<0.001),OI低于B组和C组(P<0.001)。采用直线相关分析发现AAD患者血清AD及NA质量浓度均与ET质量浓度存在正相关性,而与OI呈负相关性。结论血清儿茶酚胺浓度的升高可能与AAD患者急性肺损伤有关。
Objective To investigate whether elevated serum catecholamines in patients with acute aortic dissection (AAD) and the relationship between serum catecholamine concentration and oxygenation index (OI) were studied. Methods From April to December 2013, 38 patients with AAD in group A, 28 patients with aortic aneurysm in group B and 22 patients with angina pectoris in group C were enrolled in the study. The clinical data of all patients were collected. OI was collected and the blood samples were collected for determination of serum adrenaline (AD), noradrenaline (NA), endotoxin (ET) serum concentrations. By comparing the above three indicators in three groups of patients, we observed whether serum catecholamine concentration increased in patients with AAD. The linear correlation analysis was used to analyze the relationship between serum catecholamine concentration and ET concentration and OI in AAD patients. Results The clinical data of the three groups showed no significant difference. Serum concentrations of AD, NA and ET in group A were significantly higher than those in groups B and C (P <0.001), while those in group A were lower than those in groups B and C (P <0.001). Linear correlation analysis showed that there was a positive correlation between serum AD and NA concentrations in patients with AAD and ET, but negatively correlated with OI. Conclusions The increase of serum catecholamine concentration may be related to the acute lung injury in AAD patients.