Investigation Of The Association Of Serum SP,CGRP,NE,cTnI With Intra-operative Cardiovascular Events In Diabetic Patients

Objective:Our study examines the changes of Substance P(SP)? Calcitonin gene-related peptide(CGRP)release in the circulation is related to perioperative myocardial injury in diabetic patients of different stress state.Methods:55?61 patients selectively underwent Laparoscopic cholecystectomy(LC)?Posterior lumbar interbody fusion(PLIF)were chosen,then divided into two groups(the control group ? the diabetes mellitus group).The variation of heart rate,heart rhythm,blood pressure,ST-T segment,pulse oxygen saturation were monitored.The volume of bleeding and introvenous infusion,operative time,blood glucose(at the pre-operative and the end-operative)were recorded.Blood samples were taken from elbow vein at pre-anesthesia induction,the end of the operation and the first postoperative day.Substance P(SP)? Calcitonin gene-related peptide(CGRP)? Cardiac troponin I(cTnI)?norepinephrine(NE)were determined by the methods of Enzyme-linked immunoassay(ELISA).Results:1.Plasma cTnI level(3.82�0.60ng/mL,6.24�1.01ng/mL)elevated significantly(P< 0.05)in those who suffered adverse cardiovascular events,furthermore the CGRP contents(61.37�11.45ng/mL,61.91�11.52ng/mL);SP contents(3.19�0.48ng/mL,2.96�0.43ng/mL)in those people were decreased dramatically(P< 0.05);2.Increased ofplasma cTnI content(4.88�0.94ng/mL,5.64�1.16ng/mL)and high incidence of adverse cardiovascular event(52%),decreased of plasma CGRP content(58.00�15.90ng/mL,57.93�16.00ng/mL);SP content(3.13�0.41ng/mL,2.98�0.45ng/mL)were detected in the diabetic patients,compared with normal people.3.Plasma CGRP in neither diabetes mellitus group nor the control group at the end of operation didn't change obviously(P>0.05).The level of Plasma SP at the end of operation in either diabetes mellitus group or the control group were lower.The change of plasma SP?CGRP in the normal people who underwent PLIF(0.84�0.16ng/mL;0.91�0.2ng/mL)was significant(P< 0.05)than those who underwent LC(0.11�0.09ng/mL;0.19�0.11ng/mL),however no matter what kind of surgery the diabetic patents underwent,there was no obvious change of plasma SP?CGRP unfortunately.Conclusion:The incidence of perioperative myocardial injury may be enhanced in diabetic patients,possibly due to reduction of plasma SP?CGRP in these people.