口服维生素E对肢体缺血再灌注损伤的影响  

Effect of Vitamin E on Lower Extremity Ischemia-reperfusion Injury of Limb

作　　者：张元贵[1] 邵维忠[2] 纪凡层[2] 

机构地区：[1]潍坊医学院麻醉系 [2]山东省潍坊市人民医院麻醉科,山东潍坊261041

出　　处：《中国现代医生》2009年第6期5-6,8,共3页China Modern Doctor

摘　　要：目的研究维生素E对止血带引起的肢体缺血再灌注损伤的影响。方法36例术中使用止血带的单侧下肢手术患者,ASAⅠ～Ⅱ级,随机分为两组:对照组(C组,n=18)和治疗组(T组,n=18)。治疗组术前5～6h口服维生素E 300mg,对照组术前5～6h口服安慰剂。两组均用连续硬膜外麻醉。分别于止血带充气前(T1)、止血带放气前1min(T2)、止血带放气后15min(T3)各抽取患侧下肢静脉血2mL检测血清MDA和CK的水平。结果与止血带充气前T1时点比较,MDA(丙二醛)在对照组T2时点显著降低(P<0.05),T3时点显著降低(P<0.01)。与对照组相比:治疗组MDA在T2时点显著降低(P<0.05),T3时点显著降低(P<0.01),CK(肌酸激酶)在对照组T3时点显著升高(P<0.01),治疗组在T3时点显著升高(P<0.05)。与对照组相比:治疗组在T3时点显著降低(P<0.01)。结论术前5～6h口服维生素E 300mg对下肢缺血再灌注损伤有一定的保护作用,可抑制氧自由基代谢物MDA的产生并减少CK的产生。Objective To assess the effect of vitamin E on the changes in lipid peroxides（MDA） and plasma enzymes（CK） after ischemia-reperfusion of lower extremity. Methods Thirty-six patients（ASA Ⅰ -Ⅱ） undergoing lower limb operations were studied. The patients were randomly divided into 2 groups ： 18 cases in group T （to take orally vitamin E before operation 5 - 6h）, 18 cases in group C （to take placebo before operation 5 - 6h）. Continual epidural anesthesia was performed in both groups. Blood samples were obtained before fastening tourniquet,at lmin before release of tourniquet and at 15min after release of tourniquet. MDA and CK were measured and compared. Results MDA before lmin of reperfusion in group C was significantly less decreased at T2（P〈0.05） and at T3（P〈0.01） than T1. In group T, MDA concentrations were significantly increased at T2（P〈 0.05） and at T3（P〈 0.01 ）, compared with group C at the same time points. In group C CK level decreased at T2, T3 whereas there was significant change only at T3 （P〈0.01）. CK level was lower at T3 in group T than that in group C（P〈 0.01 ）. Conclusion To take vitamin E before operation 5 - 6h can inhibit the production of MDA and reduce the production of CK,sbowing protective effect against ischemia and reperfusion injury.

关 键 词：维生素E 止血带 再灌注损伤 丙二醛 

分 类 号：R614[医药卫生—麻醉学]