人工全髋关节置换对红细胞脂质过氧化的影响  

Effect of total hip replacement on lipid peroxide in erythrocytes in the elderly

作　　者：王友华[1] 刘璠[1] 王洪[1] 沈施仁[1] 吴菊[1] 

机构地区：[1]南通大学附属医院骨科,226001

出　　处：《江苏医药》2006年第7期615-617,共3页Jiangsu Medical Journal

摘　　要：目的探讨人工全髋关节置换术对老龄患者红细胞脂质过氧化的影响及维生素E、1,6-二磷酸果糖(FDP)对围手术期红细胞脂质过氧化的防治作用。方法44例老年股骨颈骨折患者,于硬膜外阻滞麻醉下行人工全髋关节置换术,随机分为对照组、应用维生素E组、术中应用FDP组及术前应用维生素E联合术中应用FDP组,每组11例。各组分别在手术开始前、术后1、3、5、7、14d抽取血样,测定红细胞中丙二醛(MDA)和铜-锌-超氧化物歧化酶(Cu-Zn-SOD)的含量。结果老龄患者人工全髋关节置换术后红细胞中MDA明显比术前增高(P<0·05),而Cu-Zn-SOD的含量则明显比术前降低(P<0·05);术前应用维生素E联合术中应用FDP比单纯应用维生素E或FDP能在围手术期更有效地保护红细胞免受脂质过氧化的损伤(P<0·05)。结论临床上老年患者行人工全髋关节置换术,应提倡术前口服维生素E和术中应用FDP,以预防围手术期氧自由基和过氧化脂质等有害因子对红细胞的破坏,以及因红细胞损伤可能出现的深静脉血栓形成等并发症的发生。Objective To evaluate the influence of total hip replacement（THR） on the lipid peroxidation in erythrocytes,and the effect of prophylactic treatment of vitamin E and fructose, 1, 6- diphosphate（FDP） on it. Methods Fourty-four patients of femoral neck fractures were divided into control group, vitamin E group, FDP group and vitamin E combined with FDP group. All patients were received THR under epidural anesthesia. Blood samples were taken for determination of MDA and Cu-Zn-SOD on the day before and the 1 st,3 rd,5 th,7 th and 14 th day after operation. Results MDA level in erythrocytes increased significantly after THR compared with that before operation （P〈 0. 05） ,while Cu-Zn-SOD level decreased significantly（P〈0. 05）. The changes were much less in the patients given oral vitamine E before operation and intravenous infusion of FDP during operation. Conclusion It is suggested that vitamine E and FDP may be given as above to protect the patients undergoing THR from lipid peroxide injury.

关 键 词：髋关节置换术 过氧化脂质 红细胞 维生素E 1 6-二磷酸果糖 

分 类 号：R687.4[医药卫生—骨科学] R963[医药卫生—外科学]