丙泊酚和异氟烷对颅内肿瘤患者炎性细胞因子的影响比较  

Comparative Study of Propofol and Isoflurane on Inflammatory Cytokines in Patients with Intracranial Neoplasm

作　　者：徐鲁峰[1] 潘雯[2] 宫建[3] 郭凤[4] 封瑞[4] 崔文瑶[5] 吕福斌[1] 高成杰[1] 

机构地区：[1]济南军区总医院麻醉科,济南250031 [2]辽宁省疾病预防控制中心,沈阳110005 [3]沈阳药科大学生命科学与生物制药学院临床药学教研室,沈阳110016 [4]中国医科大学药学院药物毒理学教研室,沈阳110001 [5]中国医科大学附属第一医院麻醉科,沈阳110001

出　　处：《医药导报》2014年第9期1157-1159,共3页Herald of Medicine

基　　金：沈阳市社会发展科技攻关项目(F11-262-9-04)

摘　　要：目的：观察丙泊酚和异氟烷对颅内肿瘤患者炎性细胞因子[肿瘤坏死因子α（ TNF-α）、白细胞介素1（ IL-1）和细胞黏附分子-1（ICAM-1）]的影响,探讨丙泊酚脑保护作用机制。方法颅内肿瘤手术患者168例,随机分为丙泊酚组和异氟烷组,各84例。丙泊酚组血浆靶控输注丙泊酚3～6μg · mL-1,异氟烷组给予1%～2%异氟烷持续吸入。患者均于麻醉诱导前、手术后0 h、手术后24 h和手术后48 h抽取静脉血,测定血清TNF-α、IL-1和ICAM-1的含量。结果两组患者手术后血清TNF-α、IL-1和ICAM-1含量均呈上升趋势。手术后24 h,丙泊酚组和异氟烷组TNF-α分别为（69.11±8.95）,（76.26±11.28）μg·mL^-1；IL-1分别为（21.57±3.19）,（29.58±4.38） ng·L^-1；ICAM-1分别为（1.63±0.24）,（1.94±0.29） g·L^-1；手术后48 h,丙泊酚组炎性细胞因子含量也均较异氟烷组降低（P〈0.05或P〈0.01）。结论丙泊酚靶控输注比异氟烷吸入可更好地降低颅内肿瘤患者手术后炎性反应水平,这可能是丙泊酚发挥脑保护作用的机制之一。Objective To explore the neuroprotective mechanism of propofol by comparing the influence of propofol and isoflurane on inflammatory cytokines （ TNF-α、IL-1、ICAM-1 ） in patients with intracranial tumors. Methods One hundred and sixty-eight patients with intracranial neoplasm were randomly divided into two groups：the propofol （ Group P） and isoflurane （Group I）,84 cases in each. Patients were given with propofol （3-6 μg·mL-1） by plasma target-controlled infusion or with continuously inhaled isoflurane （ 1%-2%） , respectively. The serum levels of TNF-α, IL-1 and ICAM-1 were detected before anesthesia and at 0,24,and 48 h after operation. Results The serum levels of TNF-α,IL-1 and ICAM-1 were significantly increased after operation as compared to baseline in both groups. The serum level of TNF-α was（69. 11±8. 95） and （76. 26±11.28） μg·mL-1,IL-1 was（21.57±3.19） and （29.58±4.38） ng·L-1,and ICAM-1 was （1.63±0.24）and （1.94±0.29） g·L-1 at 24 h post operation in Group P and Group I,respectively. These inflammatory cytokine levels were significantly higher in group I compared to group P at 24 and 48 h after operation （P〈0. 05 or P〈0. 01）. Conclusion The target-controlled infusion of propofol brings about lower level of inflammatory reaction than isoflurane inhalation in patients with intracranial neoplasm,which may attribute to the mechanism of brain protection against injury.

关 键 词：丙泊酚 异氟烷 肿瘤 神经组织 肿瘤坏死因子 白细胞介素 细胞黏附分子 

分 类 号：R971.2[医药卫生—药品] R739.41[医药卫生—药学]