尼莫地平对老年手术患者血清S100β蛋白肿瘤坏死因子α及白细胞介素6的影响  

Effect of nimodipine in elderly surgical patients with serum S100β protein,tumor necrosis factor alpha and interleukin-6

作　　者：张盛全 邓田[2] 邓林[2] 

机构地区：[1]重庆市人口和计划生育科学技术研究院,400011 [2]重庆市中医院麻醉科

出　　处：《安徽医学》2013年第7期949-951,共3页Anhui Medical Journal

摘　　要：目的观察术中静脉用尼莫地平是否可以降低老年手术患者血清S100β蛋白、肿瘤坏死因子α及白细胞介素6的含量。方法选择我院年龄65～80岁的住院行择期腹腔镜胆囊摘除手术患者180例(ASAⅠ～Ⅱ级),严格按照纳入和排出标准筛选后,随机分成两组(即Ⅰ组、Ⅱ组),每组90例。每组患者入室后,均在相同的时段(麻醉前30 min到手术结束),Ⅰ组:静脉持续泵注尼莫地平;Ⅱ组:静脉持续泵注生理盐水。麻醉都选用气管插管静吸复合全麻,术后均采用PCIA。测定所有患者分别在麻醉前(T0)、术中40 min(T1)、术毕(T2)、术后24 h(T3)4个时间点抽取静脉血查血S100β蛋白、肿瘤坏死因子α(TNF-α)及白细胞介素6(IL-6)的含量。结果Ⅰ组和Ⅱ组在T1、T2时血清S100β蛋白、TNF-α及IL-6含量与T0相比均增加(P<0.01)。T2时达高峰,T3时恢复至T0水平。Ⅰ组在T1、T2时间点较Ⅱ组同时间点血清S100β蛋白、TNF-α及IL-6的含量低,差异具有统计学意义(P<0.05)。结论尼莫地平处理能降低老年患者腹腔镜胆囊摘除手术术中、术毕血清S100β蛋白、TNF-α及IL-6的含量,从而降低老年患者术后认知功能障碍的发生率。Objective To observe whether nimodipine pretreatment can or cannot reduce the contents of serum S10013 protein, TNF-α and IL - 6 in elderly surgical patients. Methods Altogether 180 patients in our hospital from age 65 to 80 were selected for elective lap- aroscopic gallbladder removal surgery （ASAⅠ - Ⅱ） , and they were randomly divided into two groups, with 80 cases in each group. For each group of patients, in the same period of time （before anesthesia 30 minutes to the end of the surgery）, groupⅠ was received continuous intra- venous infusion of nimodipine, and group Ⅱ of normal saline. Endotracheal intubation static inhalation anesthesia was selected, and PCIA was used Postoperatively. Venous blood SlO0beta protein, tumor necrosis factor alpha （ TNF - alpha） and interleukin 6 （ IL - 6 ） levels at 4 time points, namely before anesthesia（ TO ）, intraoperative （ T1）, end of surgery （ T2 ）, and 24 hrs of postoperative （ T3 ） were determined in all patients. Results For group I and II, the content of serum S100beta protein, TNF -α and IL -6 at TI, T2 was increased significantly, compared with TO, and the difference was statistically significant （P 〈 0.05 ）. The content of serum S100beta protein, TNF-α and IL -6 reached a peak at T2, and restored to the level of TO at T3. The serum S100beta protein, TNF -α and IL -6 in Group I at T1, T2 was de- creased compared to the same time point of group II, and the difference was statistically significant （P 〈 0.05 ）. Conclusion Nimodipine pretreatment can reduce the content of serum S100beta protein, TNF -α and IL -6 in elderly patients with laparoscopic gallbladder removal surgery at the intraoperative （T1）, end of surgery （T2） , 24 hrs of postoperative （T3）, thereby reducing the incidence of postoperative cogni- tive dysfunction in elderly patients.

关 键 词：尼莫地平 老年手术患者 血清S100Β蛋白 肿瘤坏死因子Α 白细胞介素6 

分 类 号：R657.4[医药卫生—外科学]