不同吸入麻醉药预处理对体外循环心脏手术患者围手术期S10013蛋白与神经元特异性烯醇化酶水平的影响  

Effects of different inhalation anesthetic pretreatment on serum SIOOI5 protein and neurone specific enolase in infants during open-heart surgery under extracorporeal circulation

作　　者：李灿[1] 郑蓉[1] 

机构地区：[1]华中科技大学荆州市中心医院麻醉科,湖北荆州434020

出　　处：《中国医师进修杂志》2013年第3期7-10,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨先天性心脏病患儿体外循环（ECC）下心内直视手术中吸入麻醉药预处理对脑的保护作用。方法45例年龄≤3岁的先天性心脏病患儿按随机数字表法分为七氟烷预处理组、异氟烷预处理组和对照组，每组15例。预处理组行快速麻醉诱导插管后，持续吸入1．0～1．5MAC七氟烷或异氟烷，对照组不采取预处理措施。三组在术前（T1）、ECC开始5min（T2）、阻断主动脉时（L）、ECC后30min（T4）、ECC结束时（P＞5）、ECC结束后6h（T6）、ECC结束后24h（T7）分别采集血液，采用酶联免疫吸附法检测并比较血清S10013蛋白和神经元特异性烯醇化酶（NSE）水平变化情况。结果T。三组血清S10013蛋白水平比较差异元统计学意义（尸〉0．05）；T。七氟烷预处理组、异氟烷预处理组血清S10013蛋白水平与T2～L比较差异均无统计学意义（P〉0．05）；T2～B七氟烷预处理组和异氟烷预处理组血清S100B蛋白水平比较差异无统计学意义（P〉O．05）；对照组T4～T6血清S100B蛋白水平高于T。（P〈0．05）；T4～T6七氟烷预处理组、异氟烷预处理组血清S100p蛋白水平均低于对照组[（O．454-0．31）、（0．474-0．35）IXg／L比（0．734-0．31）μs／L，（0．534-0．33）、（0．544-0．36）IXs／Lμ（O．914-0．30）μg／L，（0．474-0．34）、（0．494-0．35）μg／L比（0．79-t-O．40）μg／L，P〈0．05J。T1三组血清NSE水平比较差异无统计学意义（P〉0．05）；T。七氟烷预处理组、异氟烷预处理组血清NSE水平与T2。B比较差异无统计学意义（P〉0．05）；对照组T；血清NSE水平与L—T7比较差异有统计学意义（P〈0．05）；T2一T7七氟烷预处理组和异氟烷预处理组血清NSE水平比较差异无统计学意义（P〉0．05）；T4～L七氟烷预处理组、异氟烷预处理组血清NSE水平均低于对照组[（3．264-1．34）、（3．324-1．34）μg／L比（7．20Objective To determine the brain protective effects of inhalation anesthetic pretreatment in infants undergoing open-heart surgery under extracorporeal circulation （ECC）. Methods Forty-five infants （no more than 3 years old） with congenital heart diseases who received surgical treatment were divided into 3 groups by table of random digit, sevoflurane pretreatment group （group S, 15 cases）, isoflurane pretreatment group （group I, 15 cases） and control group （group C, 15 cases）. In pretreatment group, all infants had been inhaled 1.0 - 1.5 MAC sevoflurane or isoflurane continually for over 60 min after intubation,while group C did not receive pretreatment. Blood samples were taken before （T1） and in 5 rain after ECC （T2） ,occlusion of aorta （T3）, 30 min after ECC （T4） ,end of ECC （T4）, and 6 and 24 h after the end of ECC （T6 and TT）. Serum levels of S 100β protein and neurone specific enolase （NSE） were measured by enzyme-linked immunosorbent assay. Results There was no significant difference in the serum levels of S100β protein and NSE among the 3 groups in Tl （P 〉 0.05）. There was no significant difference in the serum levels of S100β protein and NSE in group S and group I between T1 and T2-7 （P〉 0.05）. There was no significant difference in the serum levels of S100 β protein and NSE in T2 -7 between group S and group I （P 〉 0.05 ）. In group C, there were significant differences in the serum levels of SIO0 13 protein in T4-6 and NSE in T4 -7 than those in T1（ P 〈 0.05 ）. In T4-6, the serum levels of S 100 β protein and NSE in group S and group I were significantly lower than those in group C [ S100 13 protein： （0.45 ± 0.31 ）, （0.47 ± 0.35 ） μ g/L vs. （0.73 ± 0.31 ） ix g/L, （0.53± 0.33）, （0.54 ± 0.36）μ g/L vs. （0.91± 0.30）μ g/L, （0.47± 0.34）, （0.49 4±0.35 ） μ g/L vs. （0.79 ± 0.40）μ g/L, P 〈 0.05; NSE： （3.26 ± 1.34）, （3.32 ± 1.34 ）μ g/L vs. （7.20 ± 2.71 ） μ g/L, （5.

关 键 词：体外循环 S100蛋白质类 磷酸丙酮酸水合酶 

分 类 号：R614[医药卫生—麻醉学]