靶控输注异丙酚对心脏瓣膜置换术患者中性粒细胞NF-κB、bcl-2表达的影响  

Effects of target-controlled propofol infusion on NF-κB or bcl-2 expression in neutrophils of patients undergone cardiac valve replacement with cardiopulmonary bypass

作　　者：冷玉芳[1] 贾鹤龄[1] 周丕均[1] 张彬[2] 

机构地区：[1]兰州大学第一医院麻醉科 [2]兰州大学第一医院心外科,甘肃兰州730000

出　　处：《兰州大学学报（医学版）》2006年第2期12-14,18,共4页Journal of Lanzhou University（Medical Sciences）

摘　　要：目的探讨体外血循环下心脏瓣膜置换术靶控输注异丙酚后对患者外周血中性粒细胞NF- κB、bcl-2表达的影响。方法择期行心脏瓣膜置换术患者60例(ASAⅡ-Ⅲ级),随机分为实验组和对照组,每组30例。实验组在麻醉诱导后靶控输注初始血药浓度为2．5μg／L的异丙酚,根据患者麻醉深度调整异丙酚血浆靶浓度,最大可达3．4μg／L,同时复合枸橼酸芬太尼、维库溴铵维持麻醉;对照组术中间断静注咪唑安定、枸橼酸芬太尼、维库溴铵维持麻醉,分别于麻醉诱导后即刻和CPB停机后30 min抽取患者中心静脉血,用流式细胞仪测定外周血中性粒细胞NF-κB、bcl-2的表达。结果中性粒细胞NF-κB、bcl-2表达,两组在CPB后均显著升高(P<0．05、P<0．01),且对照组明显高于实验组(P<0．01)。中性粒细胞数,两组在CPB后均显著升高(P<0．01),对照组明显高于实验组(P<0．01)。结论异丙酚可通过抑制中性粒细胞NF-κB、bcl-2的活化而减少炎性介质的合成,从而拮抗过度的全身炎症反应,对机体发挥保护作用。Objective To evaluate the effects of propofol by target-controlled infusion on the expression of NF-κB or bcl-2 protein in neutrophils of patients undergone cardiac valve replacement. Methods Sixty ASA Ⅱ-Ⅲ patients undergone cardiac valve replacement were randomly divided into two groups： experimental group（n = 30） and Control group（n = 30）. Anesthesia was induced with midazolam, fentanyl and vecuronium in group experimental group. Results NF-κB and bcl-2 levels and neutrophil count were significantly increased after CPB in both groups（P 〈0.05, P 〈 0.01） and were significantly higher in experimental group when compared with control group（P 〈 0.01）. Conclusion Propofol can inhibit neutrophil NF-κB and bcl-2 activities and reduce the synthesis and release of inflammatory cytokines, thus it may be protective to the injured human body.

关 键 词：药物投与系统 二异丙酚 心肺转流术 中性粒细胞 NF-κB bcl-2 

分 类 号：R614.1[医药卫生—麻醉学]