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目的 :探讨前列腺增生症 (BPH)患者手术与缺血性心脏病及其并发症的内在联系。方法 :测定 36例老年患者围前列腺切除术血浆一氧化氮 (NO)、内皮素 (ET)及其比值的动态变化 ,并将有或无缺血性心脏病者分组比较。结果 :BPH患者术后 3天NO水平明显降低 (2 0 .5 3± 10 .2 4vs 6 3.10± 33 .2 7) ,ET水平明显升高(5 7.14± 2 0 .42vs 36 .71± 14.0 8) ,NO/ET比值明显下降 (0 .37± 0 .17vs 1.73± 0 .99,均P <0 .0 1) ,术后 10天仍未恢复至术前水平 (P <0 .0 1)。与无冠心病者相比 ,伴有冠心病者术后ET水平 (71.2 5± 13 .13vs 44 .5 2± 17.37)、NO/ET比值 (0 .2 8± 0 .15vs 0 .47± 0 .2 5 )失调更为明显 (P <0 .0 1) ,术后 10天有与无冠心病组之间ET水平、NO/ET比值仍有明显差异 (P <0 .0 5 )。结论 :BPH患者手术后存在着血管内皮功能障碍 ,尤以冠心病患者为甚 ,血管内皮功能损伤可能是术后心血管并发症的原因。
Objective: To investigate the relationship between surgical and ischemic heart disease and its complications in patients with benign prostatic hyperplasia (BPH). Methods: The changes of plasma nitric oxide (NO), endothelin (ET) and their ratio in 36 cases of elderly patients undergoing prostatectomy were determined. The patients with or without ischemic heart disease were divided into groups. Results: The level of NO was significantly lower in BPH patients 3 days after operation (20.53 ± 10.24 vs 6 3.10 ± 33.27) and the level of ET was significantly higher (5 7.14 ± 2.042 vs 36.71 ± 14.0 8), the NO / ET ratio decreased significantly (0.37 ± 0.17 vs 1.73 ± 0.99, all P <0.01), but not restored to the preoperative level 10 days after operation (P <0.01) ). Compared with those without coronary heart disease, the postoperative ET levels (71.2 5 ± 13.13 vs 44.52 ± 17.37), NO / ET ratio (0.28 ± 0.15 vs 0.47 ± 0 (P <0.01). There was still a significant difference in ET level and NO / ET ratio between the 10-day and non-CHD groups (P <0.05). Conclusion: There are vascular endothelial dysfunction in patients with BPH after operation, especially in patients with coronary heart disease. Vascular endothelial dysfunction may be the cause of postoperative cardiovascular complications.