东南大学学报(医学版)JSoutheastUniv(MedSciEdi)2006,Jan;25(1):73Ο75[5]VUTH,WERBZ.Matrixmetalloproteinases:effectorsofde2velopmentandnormalphysiology[J].GenesDev,2000,14:2123Ο2133.[6]BODEW,FERNANDEZΟCATALANC,GRAMSF,etal.In2sightsintoMMPΟTIMPinteractions[J].AnnNYAcadSci,1999,878:73Ο91.[7]WUK,SETTYS,MAUERSM,etal.Alteredkidneymatrixgeneexpressioninearlystagesofexperimentaldiabetes[J].ActaAnatBasel,1997,158:155Ο165.[8]EBIHARALJ,NAKAMURAT,SHIMADAN,etal.Increasedplasmametalloproteinase9concentrationsprecededevelopmentofmicroalbuminuriainnoninsulindependentdiabetesmellitus[J].AmJKidenyDis,1998,32:544Ο550.[9]TASHIROK,KOYANAGII,OHARAI,etal.Levelsofurinarymatrixmetalloproteinase29(MMPΟ9)andrenalinjuriesinpa2tientswithtype2diabeticnephropathy[J].JClinLabAnal,2004,18(3):206Ο210.[10]GIUSEPPED,MARIAAA,DIEGOG,etal.MatrixMetallo2proteinase2maybeamarkerofmicroangiopathyinchildrenandadolescentswithtype1diabetes[J].DiabetesCare,2004,27:273Ο274.[11]McLENNANSV,KELLYDJ,COXAJ,etal.Decreasedma2trixdegradationindiabeticnephropathy:effectsofACEinhi2bitionontheexpressionandactivitiesofmatrixmetalloprotein2ases[J].Diabetologia,2002,45(2):268Ο275.[12]SINGHR,SONGRH,ALAVIN,etal.Highglucosedecreasesmatrixmetalloproteinase22activityinratmesangialcellsviatransforminggrowthfactor2beta[J].ExpNephrol,2001,9:249Ο257.[13]McLENNANSV,MARTELLSKY,YUEDK.Highglucoseconcentrationinhibitstheexpressionofmembranetypemetal2loproteinasebymesangialcells:possibleroleinmesangiumaccumulation[J].Diabetologia,2000,43:642Ο648.[14]LUPIAE,ELLIOTSJ,LENZO,etal.IGFΟ1decreasescolla2gendegradationindiabeticNODmesangialcells:implicationsfordiabeticnephropathy[J].Diabetes,1999,48:1638Ο1644.[15]McLENNANSV,MARTELLSKY,YUEDK.Effectsofmesangiumglycationonmatrixmetalloproteinaseactivities:possibleroleindiabeticnephropathy[J].Diabetes,2002,51:2612Ο2618.[16]于晓燕,李才,何泽,等.糖基化终末产物对大鼠肾皮质基质金属蛋白酶2活性和表达的影响[J].中华内分泌代谢杂志,2003,19:402Ο405.[17]BARICOSWH,CORTEZSL,DEBOISBLANCM,etal.Trans2forminggrowthfactor2betaisapotentinhibitorofextracellularmatrixdegradationculturedhumanmesangialcells[J].JAmSocNephrol,1999,10:795.[18]McLENNANSV,WANGXY,MORENOV,etal.Connec2tivetissuegrowthfactormediateshighglucoseeffectsonma2trixdegradationthroughtissueinhibitorofmatrixmetallopro2teinasetype1:implicationsfordiabeticnephropathy[J].En2docrinology,2004,145(12):5646Ο5655.[收稿日期]2005Ο04Ο12[作者简介]朱炜(1978-),女,江苏南京人,医学硕士。E2mail:chzhuwei118@yahoo.com小儿麻醉新进展朱炜,邓小明(上海长海医院麻醉科,上海200043)[关键词]麻醉;小儿;术前禁食;上呼吸道感染;术后呼吸暂停;父母陪伴;综述[文献类型][中图分类号]R726.14[文献标识码]A[文章编号]1671Ο6264(2006)01Ο0073Ο03临床麻醉工作需着力从任验医学向循证医学过渡,以适应医学发展方向。作者就小儿麻醉中经常困扰麻醉医师的术前禁食、上呼吸道感染、术后呼吸暂停、父母陪伴等问题的研究进展作一综述。1术前禁食方案合理的术前禁食时间可减少胃内容物,降低误吸的发生率。1999年美国麻醉学会(ASA)公布的术前·37·禁食时间为:流质2h,母乳4h,动物乳制品6h,婴儿配方饮食6h,半流质6h,固体食物8h[1]。多少量的酸性误吸物可以导致肺损伤?过去一直认为误吸量小于0.4ml·kg-1不会出现明显的肺损伤。有研究人员认为对于灵长类动物,误吸量≤0.8ml·kg-1不会导致肺损伤。Schwartz等[2]对儿科术前禁食的围手术期研究表明,小儿若于术前2h进食清饮料(水),其胃内液体残留量(residualgastricfluidvolume,GFV)为(0.24±0.31)～(0.66±0.79)ml·kg-1。事实上...
