Lipo-PGE_1对体外循环患者围术期S100β蛋白的影响及机制  

Effects of Lipo-PGE_1 on perioperative S100β protein in patients undergoing cardiopulmonary bypass

作　　者：张小强[1] 李勇[1] 吴永兵[1] 喻东亮[1] 徐建军[1] 

机构地区：[1]南昌大学第二附属医院心胸外科,330006

出　　处：《江苏医药》2008年第7期668-670,共3页Jiangsu Medical Journal

摘　　要：目的观察前列腺素E1脂微球载体制剂（Lipo-PGE1）对心肺转流（CPB）患者围术期S100β蛋白的影响。方法30例CPB患者随机均分成Lipo-PGE1（P）组和对照（C）组。P组CPB前持续静脉泵入Lipo-PGE1 3ng·kg^-1·min^-1至手术结束；C组给予相同容量的生理盐水。两组均于麻醉后手术前（T1）、CPB后30min（T2）、开放升主动脉后1h（T3）、CPB后6h（T4）、CPB后24h（T5）采颈静球血4ml，分别测定血浆S100β、肿瘤坏死因子α（TNF-α）、丙二醛（MDA）、超氧化物歧化酶（SOD）浓度。结果组内比较，T2～T4两组S100β、TNF-α浓度较T1升高（P〈0．05或P〈0．01）。组间比较，P组T2～T4S100β、TNF-α低于C组（P〈0．05或P〈0．01）。T2～T4两组MDA浓度升高，SOD活性下降（P〈0．05或P〈0．01）。组间比较，P组T2～T4MDA浓度低于C组，SOD活性高于C组（P〈0．05或P〈0．01）。结论Lipo-PGE1可以减轻CPB患者围术期脑损伤的生化标志物S100β蛋白的表达水平，其可能机制主要是抑制炎性因子TNF-α的释放、减少MDA的产生和增加SOD活性。Objective To investigate the effects of liposomal prostaglandin E1 （Lipo-PGE1） on S100β protein in patients undergoing cardiopulmonary bypass （CPB）. Methods Thirty patients undergoing CPB were divided randomly into Lipo-PGE1 group （P） and control group （C）with 15 cases each. In group P, LipoPGE1 3 ng·kg^-1 · min＆-1 was continuously pumped after anesthesia induction and before CPB. In group C, the same volume of normal saline was used instead of Lipo-PGE1. Blood samples were taken from jugular bulb before operation （T1）, at 30 rain after initiation of CPB（T2）, 1 h after ascending aortic off-clamping （T3）, 6 h （T4） and 24 h（T5） after discontinuation of CPB for determination of plasma S100β protein, tumor necrosis factor（TNF）-a, malondialdehyde （MDA） concentrations and superoxide dismutase（SOD） activity. Results In both groups, plasma levels of S100β protein, TNF-α and MDA were significantly higher during T2-T4 than those at TI（ P〈0.05 or P〈0.01）, which were significantly lower in group P than those in group C （P〈0.05 or P〈 0.01）. SOD activity was significantly decreased during T2-T4 as compared with that at TI（P〈0.05 or P〈0. 01） ,which was remarkably higher in group P than that in group C （P〈0. 05 or P〈0.01）. Conclusion Lipo-PGE1 can reduce the expression level of S100β protein,the perioperative biochemical markers of cerebral injury, in patients undergoing CPB, which is possibly related to its inhibiting effect on the production of TNF-α, decreasing the concentrations of MDA and increasing the activity of SOD.

关 键 词：前列腺素E1脂微球载体制剂 S100Β蛋白 心肺转流 

分 类 号：R654[医药卫生—外科学]