脑苷肌肽对体外循环下心脏瓣膜置换术患者血清S100B蛋白和神经元特异性烯醇化酶浓度的影响  

Effects of cattle encephalon glycoside and ignotin injection on serum level of S100B protein and neuron specific evolase in patients undergoing cardiac valve replacement with cardiopuimonary bypass

作　　者：杨大烜[1] 杨静[1] 李立环[1] 

机构地区：[1]北京阜外心血管病医院麻醉科,100037

出　　处：《中华医学杂志》2007年第25期1746-1748,共3页National Medical Journal of China

摘　　要：目的探讨体外循环(CPB)下心脏瓣膜置换术患者血清 S100B 蛋白和神经元特异性烯醇化酶(NSE)的浓度变化以及脑苷肌肽对 S100B 蛋白和 NSE 浓度的影响。方法 40例 CPB 下心脏瓣膜置换术患者,随机分为脑苷肌肽组(A 组)和对照组(B 组),每组20例。A 组于麻醉诱导后静脉注射脑苷肌肽20 ml(每毫升含神经节苷脂50μg、多肽3.2 mg),B 组给予等容积生理盐水。分别于给药前(T1)、CPB 结束(T2)及结束后2 h(T3)、6 h(T4)、24 h(T5)各时间点采集颈内静脉球部血,以免疫夹心双抗体酶联免疫吸附测定(ELISA)法测定血清 S100B 蛋白及 NSE 浓度。结果两组S100B 蛋白及 NSE 浓度在 CPB 结束达到峰值,随后持续下降,CPB 后24 h(T5)S100B 浓度基本恢复至基础值水平(T1),而 NSE 浓度仍高于基础值。组间比较显示 B 组 S100B 浓度在 T2、T3、T4和 T5时间点均明显高于 A 组(P<0.05),B 组 NSE 浓度在 T2、T3和 T4时间点亦明显高于 A 组(P<0.05)。结论脑苷肌肽可减少体外循环心脏瓣膜置换术患者 S100B 蛋白及 NSE 的释放,可能具有一定的脑保护作用。Objective To investigate the effects of cattle encephalon glycoside and ignotin injection on serum level of S100B protein and neuron specific evolase （NSE） during cardiac valve replacement with cardiopulmonary bypass （CPB）. Methods Forty patients undergoing cardiac valve replacement with CPB were randomly divided into two equal groups： cattle encephalon glycoside and ignotin injection group （Group A, injected intravenously with cattle encephalon glycoside and ignotin 20 ml after induction of anesthesia, and control group （ Group B, injected intravenously with normal saline instead. Blood samples were taken from the jugular bulb after induction of anesthesia （ T1 ）, immediately, and 2h, 6h, and 24 h after the discontinuation of CPB （ T2, T3, T4, and T5 ） for determination of serum levels of S100B protein and NSE. Results The serum levels of S100B protein and NSE of both groups were significantly increased after CPB, and then gradually decreased. At the time point T5, the serum levels of S100B protein of both groups decreased to near the baseline levels （T1 levels ）, but the serum levels of NSE remained high in both groups. At the time points T2, T3, T4 and T5 , the serum levels of SIOOB protein were significantly higher in Group B than in Group A （ all P 〈 0.05）. At the time points T2, T3, and T4, the serum levels of NSE was significantly higher in Group B than in Group A （ all P 〈 0.05 ）. Conclusion Cattle encephalon glycoside and ignotin injection decreases the serum levels of S100B protein and NSE and has cerebral protective effect during cardiac valve replacement with CPB to a certain degree.

关 键 词：神经节苷脂类 心肺转流术 脑损伤 

分 类 号：R654.2[医药卫生—外科学]