异丙酚在成人体外循环中抗氧化效应的研究  

Antioxidant potential of propofol during cardiopulmonary bypass in adults

作　　者：张诗海[1] 姚尚龙[1] 

机构地区：[1]同济医科大学附属协和医院麻醉科,武汉市430022

出　　处：《中华麻醉学杂志》2000年第10期594-596,共3页Chinese Journal of Anesthesiology

摘　　要：目的　探讨异丙酚在体外循环 (CPB)心脏直视手术中的抗氧化效能。方法　选择在CPB下行心脏直视手术的成年病人 30例。主动脉阻断后 ,A组和B组病人分别给予异丙酚 0 1mg·kg-1·min-1和芬太尼 5 μg·kg-1·min-1维持麻醉。两组病人分别于麻醉前、CPB前、CPB 30min、CPB结束时、CPB后 1h、手术结束时、以及术后 12和 2 4h取动脉血测定红细胞中 6 磷酸葡萄糖脱氢酶 (G 6 PD)和磷酸果糖激酶 (PFK)的活性、红细胞中总的还原型谷胱甘肽 (GSH)和氧化型谷胱甘肽 (GSSG)的含量 ,并计算GSH/GSSG的比值。结果A组病人的G 6 PD和PFK活性、GSH/GSSG比值在CPB中及术后保持不变。B组病人的G 6 PD的活性从CPB 30min开始显著升高 ,术后 12h后恢复至麻醉前水平 ;PFK活性及GSH/GSSG比值从CPB 30min开始显著降低 ,术后 12h后恢复至麻醉前水平。结论　异丙酚能够显著降低体外循环中自由基的活性 。Objective To investigate the antioxidative potential of propofol in adults undergoing open-heart surgery with cardiopulmonary bypass (CPB) Methods Thirty patients scheduled for cardiac procedures with CPB were selected Propofol (01 mg·kg -1·min -1, group A) or fentanyl (5μg·kg -1·min -1, group B) was administered to maintain anesthesia after aorta was cross-clamped Blood samples were drawn pre-anesthesia, pre-CPB, 30 min following CPB, at the end of CPB, 1h after CPB, at the end of operation, 12 and 24 h postoperatively RBC suspension was prepared to measure the erythrocyte glucose-6-phosphate dehydrogenase (G-6-PD) and phosphofructokinase (PFK) activities, total erythrocyte reduced glutathione (GSH) and oxidized GSH (GSSG) and GSH/GSSG ratio was calculatedResults In group A, G-6-PD and PFK activities and GSH/GSSG ratio remained unchanged significantly during CPB and postoperatively In group B, G-6-PD activity increased and PFK activity and GSH/GSSG ratio decreased significantly from 30th min of CPB to 12th h postoperativelyConclusions Propofol attenuates free radical activity during CPB to reduce the free radical-induced injury, while fentanyl has no effect on free radical reduction during CPB

关 键 词：体外循环 抗氧化效应 异丙酚 心肺转流术 

分 类 号：R654.1[医药卫生—外科学]