乌司他丁预处理对颅内动脉瘤夹闭术患者脑保护作用  

Effects of ulinastatin on concentration of jugular tumor necrotic factor and spinal fluid S100B protein in patients undergoing intracranial aneurysm clipping

作　　者：黄焕森[1] 何荣芝[1] 苏凤华[1] 郑进[1] 

机构地区：[1]广州医学院第二附属医院麻醉科,广州510260

出　　处：《广东医学》2009年第10期1483-1485,共3页Guangdong Medical Journal

基　　金：广东省医学科研基金资助项目(编号:A2006291)

摘　　要：目的观察乌司他丁预处理对颅内动脉瘤夹闭术患者颈静脉血肿瘤坏死因子(TNF-α)和脑脊液S100B蛋白含量的影响,探讨其脑保护作用。方法26例择期颅内动脉瘤夹闭术患者,随机分为乌司他丁组(U组,n=13)和盐水对照组(C组,n=13),U组手术开始后通过外周静脉输注乌司他丁6000 IU/kg,稀释到50 mL,30 min输完,对照组静脉输注等毫升数的生理盐水。分别于手术切皮前(T1),上临时动脉夹前(T2),上临时动脉夹20 min(T3)、动脉瘤夹闭后2 h(T4)、4 h(T5)抽取颈静脉球部血液测肿瘤坏死因子含量,通过腰穿管抽取脑脊液检测S100B含量。结果与手术切皮前比较,两组患者颈静脉球部血液TNF-α含量以及脑脊液S100B蛋白在上临时动脉夹前都轻微升高(P>0.05),上临时动脉夹20 min、动脉瘤夹闭后2 h进一步升高(P<0.05),4 h后升高更明显(P<0.01)。两组之间比较,U组患者TNF-α含量和S100B蛋白含量在T3,T4,T5等时间点的升高都不如C组明显(P<0.05,P<0.01)。结论乌司他丁预处理能抑制颅内动脉瘤夹闭术围术期炎症介质的释放,减轻炎症介质介导的脑组织损伤。Objective To study the effects of ulinastatin on contents of jugula necrotic factor - a （TNF - a） and spinal fluid S100B protein in patients undergoing intracranial aneurysm clipping. Methods Twenty - six patients receiving intracranial aneurysm clipping were randomly divided into two groups. Patients in ulinastatin group （Group U, n = 13 ） were given 6000IU/kg of intravenous ulinastatin after the operation was started while patients in controlled group （ Group C, n = 13） were given normal saline. Jugular TNF- a and spinal fluid SIOOB protein were measured before operation （ T1 ） , before loading temporary aneurysm clip（ T2 ） , and 20min（ T3 ） ,2 hours（ T4 ） and 4 hours（ T5 ） after the clipping of aneurysm. Results The contents of jugular TNF - a and S100B protein both increased at T2 compared to that at T1 in both groups and further increased at T3 and T4. Both jugular TNF - a and S100B protein significantly decreased in Group U compared to that in Group C at the same time points and the effect was most significant at T4. Conclusion Ulinastatin may inhibit the release of inflammatory mediators and protect the brain in patients undergoing intracranial aneurysm clipping.

关 键 词：乌司他丁 肿瘤坏死因子 S100B蛋白 颅内动脉瘤 

分 类 号：R739.41[医药卫生—肿瘤] R576[医药卫生—临床医学]