静脉-吸入复合全身麻醉对患者内源性前阿片肽的影响  

Effects of combined intravenous and inhalaion general anesthesia on expression of endogenous opioids peptides

作　　者：王华庆[1] 徐卫平[1] 徐晖[1] 符新春 

机构地区：[1]浙江台州市第一人民医院麻醉科,318020

出　　处：《新医学》2010年第4期228-231,共4页Journal of New Medicine

基　　金：浙江省台州市科技局基金(072KY73)

摘　　要：目的:研究静脉-吸入复合全身麻醉下患者手术过程中血浆部分内源性阿片肽水平的变化和手术前后淋巴细胞内前阿片肽基因表达的变化。方法:20例美国麻醉医师协会病情分级标准(ASA)Ⅰ-Ⅱ级患者,吸入异氟醚复合靶控输注异丙酚行全身麻醉。于手术开始前,开始后20、40、60、80min抽取动脉血4ml,用放射免疫分析法检测血浆β-内啡肽(β-EP)、亮氨酸脑啡肽(LEK)、强啡肽A(DynA)的水平。手术开始前、开始后80min分别抽取动脉血2.5ml,分离淋巴细胞,逆转录聚合酶链反应(RT-PCR)法检测前强啡肽原(PPD)和前脑啡肽原(PPE)的基因表达水平。结果:手术开始后各时间点血浆β-EP和LEK水平均较手术开始前升高(P<0.05);DynA水平在手术开始后20、40min较手术开始前升高(P<0.05);手术开始后80min淋巴细胞PPD/β-actin和PPE/β-actin较手术开始前均明显升高(P<0.05)。结论:静脉-吸入复合全身麻醉手术过程中患者外周血阿片肽水平升高,一些前阿片肽基因表达明显增加。Objective：To investigate the changes of some endogenetic opioids peptides and the expression of preprodynorphin（PPD） and preproenkephalin（PPE） gene in patients under intravenous combined with inhaling general anesthesia during operation.Methods：Twenty cases of patients with ASAⅠ-Ⅱ were treated with intravenous propofol using target-controlled infusion（TCI） combined with inhaling isofluran.β-endorphin,Leucine-enkephalin and Dynorphin A were measured with radioimmunoassay at 0,20,40,60,80 min since the beginning of operation.Blood was taken at 0,80 min and the expression of PPD and PPE genes of lymphocytes were tested with RT-PCR.Results：The plasma levels of β-endorphin and LEK patients were significantly increased at 20,40,60,80 min since the beginning of operation as compared with 0min,and Dynorphin A was increased at 40,60 min since the beginning of opertation.The expression of PPD and PPE genes at 80 min since the beginning of operation is higher than that before the beginning of operation.Conclusion：The expression of pre-opioids peptides genes increased in patients under intravenous combined with inhaling general anesthesia during operation.

关 键 词：全身麻醉 内源性阿片肽 前强啡肽原 前脑啡肽原 

分 类 号：R614[医药卫生—麻醉学]