倍他乐克对非心脏手术患者围术期外周血淋巴细胞β-中华麻醉在线.doc

倍他乐克对非心脏手术患者围术期外周血淋巴细胞β-AR基因表达的影响 杨雪媛 吴新民 【摘要】 目的 评价倍他乐克对非心脏手术患者围术期(PBL)中β肾上腺素受体(β-AR)基因表达的影响 方法 例择期非心脏手术的有明确冠心病或高危因素患者，随机分为2组，A组为对照组(n=)，B组为倍他乐克组(n=)，从术前2小时一直到术后30天，口服或静注倍他乐克PCR检测淋巴细胞中β1-AR与β2-AR的mRNA表达水平；分析倍他乐克不同时间对淋巴细胞中β1-AR和β2-AR的mRNA表达的影响。结果PBL中β1-ARmRNA在术后15天，术后30天较术前均明显增加(7.04±3.37 vs 2.66±2.36 P＜0.01; 8.94±4.75 vs 2.66±2.36 P＜0.01)；而A组的β2-ARmRNA及B组的β1-ARmRNA、β2-ARmRNA在手术前后没有显著变化(P＞0.05) 结论 倍他乐克mRNA的表达 【关键词】 倍他乐克；； Effects of Betaloc on perioperative expression of lymphocytic β-AR genes in patients undergoing noncardiac surgery YANG Xue-yuan, WU Xin-min, ZHU Jiang-hua. Department of Anesthesiology，First Hospital，Peking University，Beijing 100034，China【Abstract】Objective To assess the effects of Betaloc on perioperative expression of lymphocytic β-AR genes in patients undergoing noncardiac surgeryMethods 34 patients undergoing selective noncardiac surgery with definite coronary artery disease(CAD) or at high risk for CAD were enrolled in the study. They were randomized to 2 groups, 16(Group B) were assigned to the Betaloc group and 18(Group A) to the control group. Betaloc was given orally or intravenously from 2h before surgery to 30 days after surgery. Peripheral blood lymphocytes ( PBL) were collected 1 day before surgery,15 days after surgery and 30 days after surgery. The expressions of lymphocytic β1-AR mRNA and β2-AR mRNA were analysed by real time PCR; The effects of Betaloc and time on expression of lymphocytic β1-AR mRNA and β2-AR mRNA were analysed. Results The postoperative β1-AR mRNA level in PBL of Group A was significantly higher when compared with preoperation (7.04±3.37 vs 2.66±2.36 P＜0.01; 8.94±4.75 vs 2.66±2.36 P＜0.01); but there was no significant variation in β2-AR mRNA of Group A and β1-AR mRNA ,β2-AR mRNA of Group B perioperatively (P＞0.05). Conclusions Administration of Betaloc maintain perioperative expression of lymphocyticβ-ARmRNA in patients undergoing noncardiac surgery. 【Key words】 Betaloc ；ymphocyte ；β-adrenoceptor ；olyme