依达拉奉和1,6-二磷酸果糖联合应用对全身抗炎作用的影响  

Effects of combined use of edaravone and fructose-1,6-diphosphate against systematic inflammatory response

作　　者：舒雅[1] 何爱萍[1] 于金贵[2] 齐峰[2] 赵俊莺 韩彬[1] 

机构地区：[1]西安医学院附属医院麻醉科,710077 [2]山东大学齐鲁医院麻醉科

出　　处：《临床麻醉学杂志》2010年第4期281-283,共3页Journal of Clinical Anesthesiology

基　　金：山东省教育厅(j05156);山东省自然科学基金(y2006C56)

摘　　要：目的探讨氧自由基清除剂依达拉奉和能量代谢调节剂1,6-二磷酸果糖(FDP)联合应用对在心肺转流(CPB)下行心脏瓣膜置换手术患者的全身抗炎作用的影响。方法瓣膜置换术患者40例,随机分为依达拉奉组(A组)、FDP组(B组)、联合用药组(C组)和对照组(D组),每组10例。A组将依达拉奉0.5 mg/kg一次性加入CPB预充液中,B组于主动脉阻断前15 min静脉滴注FDP 200 mg/kg,C组为A、B两组药物的联合使用,D组给予等量生理盐水。分别于切皮前(T1)、主动脉阻断前(T2)、CPB停止2 h(T3)6、h(T4)和术后24 h(T5)采集桡动脉血测定血浆超氧化物歧化酶(SOD)、丙二醛(MDA)、肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6I、L-8及IL-10水平,记录心脏复跳情况、心血管活性药物的应用情况及术后24 h创面引流量。结果与D组比较,其他三组能显著减少血浆SOD活性降低的幅度,降低血浆MDA、TNF-αI、L-6I、L-8的升高幅度,增加IL-10的升高幅度(P<0.05),以C组作用最为明显。结论 CPB主动脉阻断前给予依达拉奉或FDP均可减轻自由基反应,抑制全身炎性反应,且两者联合用药作用更明显。Objective To study the effects of combined use of edaravone and fructose-1, 6 diphosphate（FDP） against systematic inflammatory response in patients undergoing cardiac valve replacement under cardiopulmonary bypass（CPB）. Methods Forty patients undergoing cardiac valve replacement were randomly divided into 4 groups with 10 cases each. Edaravone 0. 5 mg/kg was added into cardioplegia solution before CPB in group B. FDP 200 mg·kg was intravenously infused before aorta-clamping in group C. Edaravone and FDP were co-administered in group D. Same volume of saline was infused intravenously in group A. Plasma superoxide dismulase（SOD） activity and levels of malondialdehyde（MDA）, TNF-α, IL-6, IL-8 and IL-10 were measured before surgery （T1）. before aortic-clamping（T2）,at 2 h （T3） and 6 h （ T4 ） after CPB and 24 h after operation （ T5 ）. Results Compared to group D, the reduction of plasma SOD activity and the increases in plasma MDA, TNF a, IL-6 and IL-8 were less in groups of A,B and C,and IL-10 was increased after CPB as well. Conclusion Both of edaravone and FDP,especially combined use, can effectively reduce the effects of oxygen free radical and inhibit systemic inflammatory response in the patients undergoing CPB.

关 键 词：依达拉奉 1 6-二磷酸果糖 炎性反应 

分 类 号：R654.2[医药卫生—外科学]