不同剂量异丙酚对心内直视手术病人红细胞脂质过氧化的影响  

Effects of different doses of propofol on erythrocyte lipid peroxidation in patients undergoing open heart surgery

作　　者：曹德权[1] 陈艳平[1] 常业恬[1] 李李[1] 杨锡兰[2] 

机构地区：[1]湖南医科大学附属第二医院麻醉科,长沙市410011 [2]湖南医科大学附属第二医院中心实验室,长沙市410011

出　　处：《中华麻醉学杂志》2001年第8期456-458,共3页Chinese Journal of Anesthesiology

基　　金：湖南省科委资助项目 (98SSY2 0 15 )

摘　　要：目的　观察不同剂量异丙酚对体外循环病人红细胞脂质过氧化的影响。方法　 2 7例择期心脏瓣膜替换术患者随机分成对照组 (C组 )、小剂量异丙酚组 (LP组 )和大剂量异丙酚组 (HP组 ) ,每组 9例。LP组和HP组于麻醉诱导后分别输注异丙酚 5、10mg·kg- 1 ·h- 1 至术毕。分别于术前(T1 )、转流 6 0min(T2 )、开放主动脉 15min(T3)、6 0min(T4 )和转流后 2 4h(T5)经颈内静脉采血测定血浆脂质过氧化物 (P LPO)、红细胞脂质过氧化物 (E LPO)浓度和红细胞超氧化物岐化酶 (E SOD)活性 ,并在电镜下观察红细胞形态改变。结果　三组患者体外循环后P LPO、E LPO浓度均有明显升高、E SOD活性在开放主动脉 15min(T2 )后有明显下降 (P >0 0 5 ) ,但HP组相应时间点P LPO、E LPO水平明显低于C组 ,E SOD水平明显高于C组 (P >0 0 5 )。P LPO、E LPO、E SOD水平LP组与C组比较无统计学差异 (P >0 0 5 )。结论　大剂量异丙酚具有减轻体外循环病人红细胞脂质过氧化作用。Objective To investigate the effects of different doses of propofol on erythrocyte lipid peroxidation in patients undergoing open heart surgery Methods Twenty seven adult patients with rheumatic heart disease undergoing elective value replacement were divided randomly into three groups of nine patients each: control group (group C), low dose propofol group (group LP) and high dose propofol group (group HP) The patients were premedicated with intramuscular morphine 0 08mg/kg and scopolamine 0 06mg/kg Anesthesia was induced with propofol 2 0 mg·kg -1 (group LP and HP) or midazolam 0 2mg·kg -1 (group C), fentanyl 5 0 μg·kg -1 and vecuronium 0 1mg·kg -1 After tracheal intubation the patients were mechanically ventilated Anesthesia was maintained with propofol 5mg·kg -1 ·h -1 (group LP) or 10mg·kg -1 ·h -1 (group HP) or Isoflurane inhalation (group C) in addition to fentanyl (total dose 40 60μg·kg -1 ) and vecuronium Blood samples were taken from internal jugular vein before operation (T 1), 60min after initiation of CPB(T 2), 15min (T 3) and 60min (T 4) after aorta declamping and 24h after termination of CPB (T 5) for determination of plasma and erythrocyte LPO (P LPO and E LPO) and erythrocyte SOD (E SOD) The shape of erythrocyte was also viewed under electron microscope Results The levels of P LPO and E LPO increased significantly after initiation of CPB and the level of E SOD was higher than baseline level at T 2, then decreased from T 3 to T 5 in the three groups (P<0 05) The levels of P LPO and E LPO were significantly lower in group HP than those in group C and the E SOD level was markedly higher than that in group C (P<0 05) No significant differences in P LPO, E LPO and E SOD levels were found between group LP and C Conclusions High dose propofol can alleviate erythrocyte lipid peroxidation in patients undergoing open heart surgery

关 键 词：二异丙酚 心肺转流术 红细胞 脂质过氧化物类 心内直视手术 

分 类 号：R614[医药卫生—麻醉学]