七氟醚缺血后处理对心脏瓣膜置换术中血清肌钙蛋白T和心肌细胞内活性氧簇的影响  

The effects of sevoflurane postconditioning on serum troponin T and reactive oxygen species in myocardial cells during valve replacement surgery

作　　者：魏揠琴[1] 魏继承[1] 李士林[1] 周述之[1] 

机构地区：[1]泸州医学院附属医院麻醉科,四川省泸州市646000

出　　处：《临床麻醉学杂志》2012年第4期360-362,共3页Journal of Clinical Anesthesiology

基　　金：四川省卫生厅课题基金资助项目(编号070239)

摘　　要：目的观察七氟醚缺血后处理对风湿性心脏病(RHD)患者单瓣膜置换术中血清心肌肌钙蛋白T(cTnT)和心肌细胞内活性氧簇(ROS)的影响,探讨其对缺血-再灌注心肌的保护作用。方法择期行心脏单瓣膜置换术的RHD患者24例,随机均分为两组,七氟醚缺血后处理组(S组)行1MAC七氟醚缺血后处理5min,对照组(C组)不予七氟醚缺血后处理。采集动脉血检测cTnT,采用二氯荧光素法测定心肌细胞内ROS水平。结果与术前比较,主动脉开放后1～4h时两组血清cTnT浓度均明显升高(P<0.05),但S组明显低于C组(P<0.05)。与主动脉阻断前比较,主动脉开放后1h两组心肌细胞内ROS水平均显著增加(P<0.05),但S组明显低于C组(P<0.05)。结论七氟醚缺血后处理心肌保护作用可能与抑制缺血-再灌注心肌细胞内ROS过度生成有关。Objective To observe the effects of sevoflurane postconditioning on serum troponin T（cTnT） and reactive oxygen species（ROS） in myocardial cells during valve replacement surgery in patients with rheumatoid heart disease（RHD） and explore the protective effects on myocardium with ischemia/reperfusion injury.Methods Twenty-four patients undergoing valve replacement surgery with RHD were equally randomized into sevoflurane postconditioning group（group S） and control group（group C）.One MAC sevoflurane postconditioning was conducted for 5 minutes in group S but not in group C.cTnT and ROS were detected.Results Comparing with before operation,serum cTnT increased significantly in both groups（P〈0.05） at 1-4 h after aorta-declamping.However,it was much lower in group S than in group C（P〈0.05）.ROS in myocardial cells increased significantly in both groups 1 h after reperfusion compared with before aorta-clamping（P〈0.05）.However,it was much lower in group S than in group C（P〈0.05）.Conclusion Sevoflurane postconditioning may decrease serum cTnT and ROS in myocardial cells in patients with RHD during valve replacement surgery,which may be related to the inhibition of the overprodued ROS in myocardium with ischemia/reperfusion injury.

关 键 词：七氟醚 缺血后处理 心肌 肌钙蛋白T 活性氧分类 

分 类 号：R614[医药卫生—麻醉学]