乌司他丁对老年患者全麻开胸手术炎症反应及S100β蛋白的影响  

Effects of ulinastatin on systemic inflammatory response and on S100β protein after thoracotomy in elderly patients with general anesthesia

作　　者：邵东华[1] 杭黎华[1] 吕德生[1] 袁菊芳[1] 吴进[1] 张大鹏[1] 

机构地区：[1]江苏大学附属人民医院麻醉科,江苏镇江212002

出　　处：《江苏大学学报（医学版）》2012年第6期507-509,517,共4页Journal of Jiangsu University：Medicine Edition

基　　金：镇江市社会发展基金资助项目(SH2008051)

摘　　要：目的:探讨乌司他丁对老年患者全麻开胸手术炎症反应及S100β蛋白的影响。方法:择期普通开胸手术老年患者100例,随机分为对照组和乌司他丁组,每组50例。乌司他丁组在麻醉后静脉泵注乌司他丁2×104U.kg-1,对照组则以等量的生理盐水泵注。术前、术后4 h及24 h取静脉血2 mL,用ELISA法测定血浆肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)以及S100β蛋白的质量浓度。结果:对照组和乌司他丁组在术后血浆TNF-α、IL-6水平均较手术前明显升高(P<0.05),但乌司他丁组升高的水平显著低于对照组(P<0.05)。术前和术后24 h,对照组和乌司他丁组S100β蛋白质量浓度差异无统计学意义;术后4 h,乌司他丁组S100β蛋白质量浓度显著低于对照组。结论:乌司他丁可明显抑制老年开胸患者术后炎症因子的过度释放,降低血浆S100β蛋白上升的水平,减轻中枢神经系统的损伤。Objective：To investigate the effects of ulinastatin on systemic inflammatory response and on S100β protein after thoracotomy in elderly patients with general anesthesia.Methods：One hundred senior patients,undergoing elective general open chest operation were randomly divided into 2 groups：control group（n=50） and ulinastatin group（n=50）.In ulinastatin group,ulinastatin（2×104 U/kg） was infused intravenously by pump after the induction of anesthesia;while in control group,equal volume of normal saline was given instead of ulinastatin.Two milliliters of blood samples were taken from vein before operation beginning,4 h and 24 h after operation termination for determination of TNF-α,IL-6 and S100β protein by means of ELISA.Results：The concentration of TNF-α and IL-6 elevated dramatically after operation in both groups（P0.05）,but TNF-α and IL-6 in ulinastatin group were lower than that at the corresponding time point in control group（P0.05）.The levels of S100β protein were not significantly different before operation and 24 h after operation between two groups,while 4 h after operation the levels of S100β protein in ulinastatin group were lower compared with control group.Conclusion：Ulinastatin could decrease systemic inflammatory response and blood levels of S100β protein after thoracotomy in senior patients,thus decreasing injury to the nervous system.

关 键 词：乌司他丁 炎症反应 老年患者 肿瘤坏死因子-Α 白细胞介素-6 S100Β蛋白 

分 类 号：R614.24[医药卫生—麻醉学]