在接受选择性主要腹部手术的患者中,手术前和手术后的相对血管新素II缺乏症
Katharina Krenn1, Petra Höbart1, Lukas Adam1
1Department of Anesthesia, General Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria.
Frontiers in endocrinology
|July 23, 2024
概括
大型腹部手术激活了氨酸 - 血管新生素系统 (RAS) 的两个轴,血管新生素II (Ang II) 暂时增加,随后血管新生素转化酶2 (ACE2) 升高. 这表明在外科手术后出现Ang II分解的转变.
科学领域:
- 心血管生理学心血管生理学
- 手术内分泌学手术内分泌学
- 氨素系统 (RAS) 研究研究
背景情况:
- 经典的氨酸 - 血管素系统 (RAS) 通过血管素II (Ang II) 调节血压.
- 另一种RAS,涉及血管酶转化酶2 (ACE2),调节Ang II效应,产生器官保护性.
- 其他RAS代谢物的术后变化还未得到研究.
研究的目的:
- 研究古典和替代RAS轴的周围手术动力学和平衡.
- 了解RAS代谢物在重大腹部手术期间和之后的动态变化.
主要方法:
- 35名接受重大腹部手术的患者的观察队列研究.
- 在麻醉之前,在手术期间和直至术后的第7天进行连续取血样.
- 使用质谱和ELISA对 ангиотензин I-V,Ang 1-7,Ang 1-5,ACE和ACE2进行量化.
主要成果:
- 手术诱导了两个RAS轴的快速,短暂的激活,在术后的第1天恢复到基线.
- 诱导后Ang II/Ang I比率下降,而ACE水平在术后第一天上升.
- 在手术后的第3天和第7天,ACE2水平显著增加,这与低Ang 1-7度相吻合.
结论:
- 手术后的ACE2升高可能会通过增强Ang II处理来延长Ang II/Ang I比率的下降.
- 需要进一步的研究来澄清导致相对Ang II缺乏症的术内因素以及术后ACE2升高的来源.
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