盐酸戊乙奎醚对瓣膜置换术患者脑血清S100β蛋白和神经元特异性烯醇化酶的影响  

Effect of Penehyelidine Hydrochloride on Cerebral Serum Protein S100β and Neuron-specific Enolase During Valve Replacement Surgery

作　　者：刘红波[1] 潘道波[2] 徐军美 周爱国[2] 易善元[2] 陈安基[2] 黄芙蓉[2] 郭华静[2] 罗冲[2] 

机构地区：[1]徐州医学院麻醉学院08级研究生,江苏徐州221002 [2]湖南省常德市第一人民医院麻醉科,湖南常德415000 [3]中南大学湘雅二医院,湖南长沙410000

出　　处：《医学临床研究》2011年第1期83-86,共4页Journal of Clinical Research

摘　　要：【目的】观察盐酸戊乙奎醚（PHc）对体外循环瓣膜置换术（CPB-VR）患者脑血清S100β蛋白和神经元特异性烯醇化酶（NSE）的影响。【方法】择期CPB-VR患者59例，随机分为两组：盐酸戊乙奎醚纽（P组，n=31）和对照纽（C组，n=28）。麻醉诱导前10min分别给予PHC0．02mg／kg和等体积生理盐水。于麻醉诱导后10min（T0）、转流30min（T1）、停机稳定后10min（T2）、5h（T3）和24h（T4）5个时点采集左颈静脉球血检测血清S100β蛋白和NSE浓度；记录患者手术前后24h的MMSE评分；记录患者苏醒时间（PD）、ICU生命支持时间（SD）和出院时间（DD）。【结果】血清S10β口蛋白和NSE水平组内T1～T4与T0比较均有差异（P〈0．05）；S100β蛋白组间T2、T3比较有差异（P〈0．05），P组低于C组；NSE组间T1、T2、T3、T4比较有差异（P〈0．05），P组低于C组；MMSE评分组内、组间比较均有差异（P〈0．05），P组优于C组；PD、SD组间比较无差异（P〉0．05），DD组间比较有差异（P〈0．05），P组短于C组。【结论]PHC能降低血清S100β蛋白和NSE升高水平，提高患者术后MMSE评分，缩短患者苏醒时间、ICU生命支持时间和住院时间，表明PHC能减轻CPB-VR所致的脑损伤，具有一定的脑保护作用。[Objective]To observe the effect of penehyelidine hydrochloride（PHC） on cerebral serum protein S100β and neuron-specific enolase （NSE） during valve replacement surgery with cardiopulmonary bypass （CPB-VR）. [Methods]A total of 59 patients undergoing CPB-VR were randomly divided into PHC group（group P, n = 31） and control group（group C, n =28）. Group P received PHC at 0.02mg/kg before 10min of induction, and group C received equal volume normal saline. Blood samples were obtained from right glornus jugulare after 10min of induction（T0 ）, 30min after the onset of CPB（T1 ）, 10rain at the end of CPB （T2）, 5h and 24h after CPB （T3, T4） for detecting serum S100β protein and NSE. MMSE score before and 24h after the operation was recorded. The duration of palinesthesia （PD）, life support time in the ICU（SD） and discharge time（DD） were also recorded. [Results]There was significant difference in both of serum levels of S100β protein and NSE between T1-T4 and To （ P〈0.05） within groups. There was significant difference in serum S100β protein levels at T2 and T3 among groups（ P 〈0.05）, and serum S100β protein level in group P was lower than that in group C. There was significant difference in serum NSE levels at T1, T2, T3 and T4, （ P 0.05）, and serum NSE levels in group P were lower than those in group C. There was significant difference in MMSE scores within groups and among groups （ P 〈 0.05）, and MMSE scores in group P were better than those group C. There were no differences in the PD and SD among groups（ P 〉0.05）, while there was difference in DD among groups （ P 〈0. 05）. The DD in group P was shorter than that in group C. [Conclusion]PHC can decrease the serum levels of S100β protein and NSE, improve the MMSE scores after operation and shorten the duration of palinesthesia, life support in the ICU and discharge. It shows that PHC can alleviate the brain injury caused by CPB-VR, and protect the brain.

关 键 词：心脏瓣膜假体植入 神经组织蛋白质S100/血液 磷酸丙酮酸水合酶/血液 

分 类 号：R654.2[医药卫生—外科学]