常温及低温麻醉下安氟醚及异氟醚对心肌酶、氧自由基代谢及电解质的影响  

Effects of enflurane and isoflurane on myocardial enzymes,metabilism of oxygen free radicals and electolytes in normotherimc or hypothermic rabbits

作　　者：高巨[1] 安裕文[2] 杨承祥[1] 陈恪刚[2] 

机构地区：[1]广东省佛山市第一人民医院麻醉科 [2]贵阳医学院麻醉科

出　　处：《临床麻醉学杂志》2002年第2期89-91,共3页Journal of Clinical Anesthesiology

摘　　要：目的　研究常温 ( 3 7 5℃ )及低温 ( 3 0℃ )麻醉下安氟醚及异氟醚对心肌酶、氧自由基代谢及电解质的影响。方法　健康家兔 3 2只 ,离体Langendorff灌注 ,随机分为四组 ,每组 8只。A组 ,常温 1 3MAC安氟醚的K H液灌注 ;B组 ,常温 1 3MAC异氟醚的K H液灌注 ;C组 ,低温 1 3MAC安氟醚的K H液灌注 ;D组 ,低温 1 3MAC异氟醚的K H液灌注。按不同组别要求测定冠状动脉流出液LDH、CK活性 ,心肌组织SOD、MDA及K+、Na+、Ca2 +、Mg2 +、Zn2 +含量。结果　A、B两组灌注前后LDH、CK无显著差异 (P >0 0 5 ) ,Zn2 +含量显著降低 (P <0 0 1)。与A、B两组比较 ,C、D两组CK值显著下降 (P <0 0 1) ,SOD值显著增高 (P <0 0 1) ,MDA明显降低 (P <0 0 5 ) ,Zn2 +含量显著增高 (P <0 0 1)。四组心肌Ca2 +含量明显降低 (P <0 0 5或P <0 0 1)。结论　临床常用麻醉强度的安氟醚及异氟醚对心肌细胞无直接损伤作用 ,但心肌Ca2 +、Zn2 +含量降低明显且安氟醚抑制心肌Ca2 +内流甚于异氟醚。低温下吸入安氟醚及异氟醚后能提高心肌抗氧化损伤能力 。Objective To investigate the effects of enflurane(Enf) and isoflurane(Iso) inhalation on myocardial enzymes,superoxide dismutase(SOD),malonylaldehyde(MDA) and electolyte balance.Methods Twenty four rabbit hearts were perfused by modified Krebs Hensleit buffer with langendoff device.The rabbits were randomly divided into four groups( n= 8):1 3MAC Enf at normothermia(37 5℃)(group A),1 3MAC Iso at normothermia(37 5℃)(group B),1 3MAC Enf at hypothermia(30℃)(group C),and 1 3MAC Iso at hypothermia(30℃)(group D).The changes of crectin kinase(CK) and lactate dehydrogenase(LDH) activities in the coronary effluent,SOD and MDA contents,and K +, Na +, Ca 2+ , Mg 2+ , Zn 2+ , content were measured.Results Enf and Iso produced no significant difference in LDH and CK activities( P> 0 05) at 37 5℃,while Ck activities decreased significantly at 30℃( P< 0 05).Campared with group A and group B,SOD,Zn 2+ increased and MAD decreased significantly ( P< 0 05 and P< 0 01) in group C and group D.Ca 2+ content decreased in four groups( P< 0 05 and P< 0 01).Conclusions Enf and Iso have no direct injures to the myocardial cells,but the content of Ca 2+ and Zn 2+ of myocardial cells decreased significantly at normothemia,especially during Enf inhalation.At hypothermia,Enf and Iso can enhance the ability of the myocardial cells against superoxide injury and reduce oxygen free radical production.

关 键 词：氨氟醚 异氟醚 心肌酶 氧自由基 电解质 低温麻醉 

分 类 号：R614[医药卫生—麻醉学] R971.2[医药卫生—外科学]