异氟醚对健康志愿者脑葡萄糖代谢率的影响  

Effect of isoflurane on cerebral glucose metabolic rate in humans

作　　者：于代华[1] 徐礼鲜 柴伟[1] 张惠 林树新[3] 徐海峰[4] 姚立农[1] 魏娟[5] 

机构地区：[1]第四军医大学唐都医院麻醉科,西安市710038 [2]第四军医大学口腔医院麻醉科 [3]第四军医大学基础部病理生理学教研室 [4]第四军医大学唐都医院医学科 [5]第四军医大学唐都医院护理保障中心

出　　处：《中华麻醉学杂志》2004年第10期733-736,共4页Chinese Journal of Anesthesiology

基　　金：国家自然科学基金资助项目(30271257)

摘　　要：目的 应用正电子发射断层扫描技术(PET),研究吸入不同浓度异氟醚麻醉对健康志愿者脑葡萄糖代谢率(CMRGlu)的影响。方法 选择8名志愿者,每位志愿者分别做三次PET扫描,采用MASEP CPET Plus扫描仪及18F-FDG标记技术测定CMRGIu,第一次在清醒状态下扫描作为对照(清醒组),第二、三次分别吸入0.5 MAC和1.0MAC异氟醚(分别为0.5MAC组和1.0MAC组)后进行。结果 清醒组全脑CMRGlu平均为(30.0±1.1)μmol·100mg-1·min-1,与清醒组比较,0.5MAC组降低全脑CMRGlu24%至(23.3±1.4)μmol·100 mg·min-1(P<0.05),1.0MAC组降低41％至(18.4±0.9)μmol·100mg-1·min-1(P<0.01);脑内各区葡萄糖代谢率(CMRGlu)均显著降低,而以丘脑、楔叶和扣带回降低更为显著(P<0.01);与0.5MAC组比较,1.0MAC组全脑及各脑区rCMRGu进一步降低(P<0.05)。结论 全脑及脑内各区葡萄糖代谢率在吸入异氟醚麻醉时均可显著降低,丘脑、楔叶和扣带回对吸入异氟醚麻醉更为敏感。Objective To investigate the effects of inhalation of different concentrations of isoflurane on global and regional cerebral glucose metabolic rate (CMRglu) in healthy volunteers using positron emission tomography (PET) scan.Methods The study was approved by the ethic committee of the hospital. After obtaining written informed consent we studied eight right-handed healthy volunteers (3 male, 5 female), aged 21-28 yrs. Each volunteer underwent 3 PET scans.They were fasted for 8 h prior to study. The PET scan was performed when conscious, at 0.5 and 1.0 MAC isoflurane anesthesia. The interval between two PET scans was 1 week. Scans were obtained with a MASEP CPET Plus scanner (2.0 mm resolution-FWHM) using the 18 fluorodeoxyglucose technique. Results The whole brain CMRglu averaged 30.0±1.1 μmol·100 mg-1·min-1 when the volunteer was awake. Isoflurane anesthesia significantly reduced whole-brain CMRglu by 24% to 23.3±1.4 μmol·100 mg-1·min-1 at 0.5 MAC and by 41% to 18.4±0.9 μmol·100mg-1·min-1 at 1.0 MAC (P<0.05, 0.01). Regional CMRglu was also significantly reduced by isoflurane anesthesia in a MAC - dependent manner especially thalamus, and cuneus and cingulated gyrus. Conclusion Whole brain as well as regional CMRglu decreases significantly during isoflurane anesthesia especially thalamus and cuneus and cingulated gyrus.

关 键 词：异氟醚 吸入 健康志愿者 脑葡萄糖代谢 麻醉 脑内 扣带回 结论 敏感 目的 

分 类 号：R614[医药卫生—麻醉学] R971.2[医药卫生—外科学]