平均动脉压变异率对老年下肢骨折内固定术中N-端脑利钠肽前体及超敏C反应蛋白的影响

Effect of mean arterial pressure variability on N-terminal brain natriuretic peptide precursor and high-sensitivity C-reactive protein during internal fixation of lower limb fractures in the elderly patients

  • 摘要:
      目的  探讨老年下肢骨折内固定术中平均动脉压变异率对血清N-端脑利钠肽前体(NT-proBNP)及超敏C反应蛋白(hs-CRP)水平的影响。
      方法  将180例老年下肢骨折开放复位内固定手术患者根据其术前自身合并症分为3组(冠心病组、脑梗死组、冠心病合并脑梗死组),分别观察基础平均动脉压、平均动脉压下降5%、10%及20%时血清NT-proBNP及hs-CRP的变化,分析其相关性。
      结果  血清NT-proBNP及hs-CRP随平均动脉压的下降而升高,当平均动脉压下降超过20%时升高最为显著。
      结论  平均动脉压的变化能反映患者NT-proBNP及hs-CRP指标变化水平,并以此预示术中发生心脑血管意外的可能性。

     

    Abstract:
      Objective  To observe the mean arterial pressure variability of serum N-terminal brain natriuretic peptide precursor (NT-proBNP) and high-sensitivity C-reactive protein(hs-CRP) levels during internal fixation of lower limb fractures in the elderly patients.
      Methods  A total of 180 elderly patients with open reduction and internal fixation of lower extremity fractures were divided into three groups(coronary heart disease group, cerebral infarction group, coronary heart disease combined with cerebral infarction group). The changes of NT-proBNP and hs-CRP in serum were observed when basal mean arterial pressure, mean arterial pressure decreased by 5%, 10% and 20%, respectively, and their correlation was analyzed.
      Results  Serum NT-proBNP and hs-CRP increased with the decrease of mean arterial pressure, especially when the mean arterial pressure decreased more than 20%.
      Conclusion  The change of mean arterial pressure can reflect the changes of NT-proBNP and hs-CRP in patients, which indicates that the significantlyincreased possibility of cardio-cerebrovascular accident during operation.

     

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