2型糖尿病患者手术麻醉状态下内分泌激素水平分析

目的分析2型糖尿病患者手术麻醉状态下内分泌激素水平。方法采用放射免疫测定法，对不同麻醉方式，即全身麻醉组（GA组），硬膜外麻醉组（EA组），全麻复合硬膜外麻醉组（GA＋EA组）的2型糖尿病患者术中的四碘甲状腺原氨酸（T4）、促甲状腺激素（TSH）和C-肽的浓度进行检测。结果与麻醉前比较，除EA组术后1h血清T4浓度明显降低外，其他各组不同时间的血清T4、TSH和C-肽浓度变化不大，均无统计学意义。结论与非糖尿病手术患者比较，糖尿病手术患者体内甲状腺激素代谢存在一定的不同，表现为T4水平较为稳定；由于胰岛功能障碍，糖尿病手术患者在手术应急状态下C-肽的分泌无明显变化。

Analysis of Endocrine Hormone Levels in The Type 2 Diabetic Patients under Anesthesia State

Objective ] To analysis endocrine hormone levels in the type 2 diabetic patients under anesthesia state. Methods] Radioimmunoassay was applied to determine the concentrations of tetraiodothyronine （ T4 ）, thyroid stimulating hormone （ TSH ） and C- peptide among general anesthesia group （ GA group ） , epidural anesthesia group （ EA group ） and combined general and epidural an- esthesia group （ GA ＋ EA group）. Results] Compared with the pre-anesthesia, except for obvious descending of serum T-4 concen- tration of EA group after operation for 1 hour, concentrations of T4, TSH and C-peptide in Other groups at different times not changed much, and there was no significance. Conclusion ] Compared with the Non-diabetic patients, there was some difference on the thyroid hormones metabolism in the type 2 diabetic patients on operation. The level of T4 was stable and there was no apparent change under the operation state of emergency because of the impaired function of pancreatic islets.