参附注射液预处理对体外循环下主动脉瓣置换术患者围手术期脑保护作用的影响  

Protective Effect of Shenfu Injection Pretreatment on Brain of Patients Receiving Aortic Valve Replacement Undergoing Cardiopulmonary Bypass

作　　者：邓超[1] 代志刚[1] 陈咏今[1] 董希伟[1] 

机构地区：[1]新疆石河子大学医学院第一附属医院麻醉科,新疆832000

出　　处：《中国中西医结合杂志》2013年第5期602-605,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：新疆石河子大学医学院第一附属医院科研项目(No.YL2011R09)

摘　　要：目的观察参附注射液预处理对体外循环下主动脉瓣置换术患者脑保护的作用。方法将体外循环下行主动脉瓣膜置换术的患者30例,随机分为对照组和试验组,试验组于术前5天静脉滴注参附注射液1.5mL/kg(溶于5%葡萄糖250mL中),1次/天,连续5天,麻醉诱导前30min再次静脉滴注参附注射液1.5mL/kg(溶于5%葡萄糖250mL中)。对照组静脉滴注同等剂量生理盐水,其他治疗同试验组。于麻醉诱导完成(T1),体外循环10min(T2)、30min(T3)、体外循环结束后2h(T4)、24h(T5)、48h(T6)。抽取右颈内静脉血样2mL检测S100β、神经元特异性烯醇化酶(neuron specific enolase,NSE)水平。于术前1天、术后第2天、第7天对患者进行简易智能状态检查(mini-mental state examination,MMSE)量表评分。结果两组患者T1时点S100β和NSE水平差异无统计学意义(P>0.05);与T1比较,T2、T3、T4、T5、T6时间两组患者S100β、NSE水平均增高,差异均有统计学意义(P<0.05);且试验组各时点S100β和NSE水平低于对照组,差异亦有统计学意义(P<0.05)。两组患者术后第2天MMSE评分均降低,与本组术前1天比较,差异有统计学意义(P<0.05),且对照组MMSE评分降低程度大于试验组;两组患者术后第7天MMSE评分与术前1天比较,差异无统计学意义(P>0.05)。结论参附注射液预先给药对体外循环下主动脉瓣置换术患者可产生脑保护作用。Objective To observe the protective effect of Shenfu Injection （ SFI ） pretreatment on brain of patients receiving aortic valve replacement （ AVR ） undergoing cardiopulmonary bypass （ CPB ） .Methods Thirty AVR patients undergoing CPB were randomly assigned to 2 groups , the control group and the experimental group , 15 cases in each group.SFI at 1.5 mL / kg （ dissolved in250 mL5%glucose solution ） was intravenously dripped to those in the experimental group 5 days before operation , once daily for 5 successive days.SFI at 1.5 mL / kg （ dissolved in 250 mL5% glucose solution ） was intravenously dripped to those 30 min before anesthesia induction.Equal dose of normal saline was intravenously dripped to those in the control group , and the other procedures were the same as those for patients in the experimental group.The venous blood sample （ 2 mL ） was drawn from the right internal carotid vein immediately after induction of anesthesia （ T1 ）, 10 min after CPB （ T2 ）, 30 min after CPB （ T3 ）, 2 h after CPB （ T4 ）, 24 h after CPB （ T5 ）, and 48 h after CPB （ T6 ）, thus detecting the plasma levels of S100βand neuron specific enolase （ NSE ） .And patients′ cognitive function was assessed with mini-mental state examination （ MMSE ） scale on the day before operation , the 2nd and the 7th day after operation.Results There was no statistical difference in the levels of S100βand NSE between the two groups at T1 （ P0.05 ） .There was statistical difference in the levels of S100βand NSE between the two groups at T2 ,T3 , T4 , T5 , T6 , when compared with those at T1 （ P0.05 ） .Besides , the levels of S100βand NSE at T2 , T3 , T4 , T5 , T6 were lower in the experimental group than in the control group , showing statistical difference （ P0.05 ） .The MMSE scores decreased on the 2nd day after operation in the two groups , showing statistical difference when compared with those on the day before operation （ P0.05 ） .It was lowered more obviously in the

关 键 词：参附注射液 预处理 体外循环 心脏二尖瓣膜置换术 

分 类 号：R654.2[医药卫生—外科学]