两种麻醉方法对肝脏缺血再灌注后SOD与MDA影响的比较  

Differences in Changes of Superoxide Dismutase and Malondialdehyde after Hepatic Ischemia Reperfusion Injury with Isoflurane or Propofol-remifentanil

作　　者：赵茗姝[1] 高宝柱[1] 

机构地区：[1]天津市第三中心医院麻醉科,天津300170

出　　处：《中国中西医结合外科杂志》2008年第6期549-551,共3页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:比较丙泊酚-瑞芬太尼靶控静脉麻醉与异氟烷吸入麻醉对肝脏部分切除术缺血再灌注损伤后超氧化物歧化酶和丙二醛变化。方法:30例患者随机分为丙泊酚-瑞芬太尼组(PR组)和异氟烷组(ISO组),PR组丙泊酚和瑞芬太尼血浆靶浓度分别为3.5μg/mL和4.2ng/mL,ISO组异氟烷呼气末浓度为1.5%～2.5%。分别于阻断肝门前(T1),阻断开放后即刻(T2)、30min(T3)、60min(T4),术后1d(T5)、术后3d(T6)取静脉血测血清总超氧化物歧化酶(T-SOD)、丙二醛(MDA)浓度。结果:与T1比较,T-SODPR组及ISO组T4、T5、T6显著降低(P<0.05),ISO组T5、T6显著低于PR组(P<0.05);与T1比较,MDAPR组T5、T6,ISO组T4、T5、T6显著升高(P<0.05),ISO组T4、T5显著高于PR组(P<0.05)。结论:与异氟烷麻醉组比较,丙泊酚-瑞芬太尼麻醉组的肝脏缺血再灌注损伤后超氧化物歧化酶和丙二醛变化较小,提示其对肝细胞具有一定保护作用。Objective To determine the different effects of propofol - remifentanil and isoflurane on superoxide dismutase（SOD） and malondialdehyde（MDA） after hepatic ischemia reperfusion injury（HIRI）. Methods Thirty ASA I -II patients undergoing elective partial hepatectomy were randomly divided into 2 groups（n = 15 each）： pmpofol- remifentanil group（PR） and isoflurane group（ISO）. Anesthesia was maintained with TCI of propofol and remifentanil （target plasma concentration was set at 3.5 μg/mL and 4.2μg/mL） or isoflurane inhalation（end- tidal isoflurane con- centration was 1.5 - 2.5 % ）. Venous samples were taken at preoperative （T1）, the moment after reperfusion （T2）, 30min and 60 min after reperfusion（T3, T4） and 1, 3 d after operation to measure the concentrations of T - SOD and MDA. Results T- SOD was significantly decreased at T4, T5, T6 in group PR and group ISO（P 〈0.05）,at T5, T6T- SOD in group ISO was significantly higher than that in group PR （ P 〈 0.05）. MDA was significantly increased at T5 and T6 in group PR and significantly increased at T4, T5 and T6 in group ISO（ P 〈 0.05） ; at T4 and T5 MDA in group ISO was significantly higher than that in group PR （ P 〈 0.05）. Conclusion Compared with isoflurane anesthesia, pmpofol - remifentanil anesthesia has less effect on SOD and MDA after hepatic ischemia reperfusion injury and can produce better protective effect on hepatic ischemia reperfusion injury.

关 键 词：丙泊酚 异氟烷 肝脏缺血再灌注损伤 超氧化物歧化酶 丙二醛 

分 类 号：R614[医药卫生—麻醉学] R657.3[医药卫生—外科学]