七氟醚后处理对换瓣术患者炎性因子及心肌超微结构的影响  

Effects of sevoflurane postconditioning on the cytokines and myocardial ultrastructure in cardiac valve replacement patients

作　　者：王丹[1] 徐军美 王建斌[1] 冉珂[1] 吕志平[1] 李双凤[1] 

机构地区：[1]中南大学湘雅二医院麻醉科,长沙市410011

出　　处：《临床麻醉学杂志》2012年第2期115-117,共3页Journal of Clinical Anesthesiology

摘　　要：目的研究七氟醚后处理对心脏瓣膜置换术患者全身炎性因子和心肌超微结构的影响。方法经心肺转流(CPB)瓣膜置换术患者随机分为七氟醚后处理组(S组)与对照组(C组),每组15例。S组于主动脉开放即刻经CPB输氧装置以2%七氟醚后处理15min,C组不做此处理采取全凭静脉麻醉。测定手术开始时(T1)、主动脉开放后0.5h(T2)、3h(T3)、24h(T4)时血浆IL-6、IL-10浓度,电镜下观察心肌超微结构的变化。结果与C组比较,S组T2～T4时血浆IL-6和IL-10的浓度降低(P<0.05);与T1时比较,T2、T3时两组血浆IL-6与IL-10浓度升高(P<0.05)。结论七氟醚后处理可以降低瓣膜置换术患者CPB后炎性因子的释放,减轻心肌超微结构的损伤,有利于心功能的恢复。Objective To investigate the effects of sevoflurane postconditioning on the cytokines and myocardial ultrastructure in cardiac valve replacement patients. Methods Thirty patients undergoing cardiac valve replacements were divided into control group （group C） and sevoflurane group （group S） randomly with 15 each. Patients in group S received sevoflurane for 15 mins in CPB machine after unclamping of aorta. Patients in group C received total intravenous anesthesia. The beginning of surgery （T1）, after aortic 0.5 h （T2）, aortic opening 3 h （T3）, aortic opening 24 h （%）, plasma levels of IL-6, IL-10 and myocardial ultrastructure were analyzed and compared. Results Compared with group C, plasma levels of IL-6 and IL-10 decreased in group S from T2 to T4 （P〈0.05）. Plasma levels of IL-6 and IL-10 increased at T2 and T3 compared with T1 （P〈0.05）. Conclusion Sevoflurane post-conditioning can decrease cytokines and reduce myocardial ultrastructural injury in cardiac valve replacement surgery. It may benefit for the cardiac function.

关 键 词：七氟醚后处理 瓣膜置换术 炎性因子 心肌超微结构 

分 类 号：R614[医药卫生—麻醉学]