葛根素预防体外循环心脏直视术患者脑损伤的效果  

Efficacy of puerarin for prevention of brain injury in patients undergoing open heart surgery under cardiopulmonary bypass

作　　者：刘平[1] 吴周全[1] 张元锋[1] 李立[1] 恽惠方[1] 

机构地区：[1]南京医科大学附属常州第二人民医院麻醉科,常州市213003

出　　处：《中华麻醉学杂志》2014年第12期1421-1424,共4页Chinese Journal of Anesthesiology

摘　　要：目的 评价葛根素预防体外循环（CPB）心脏直视术患者脑损伤的效果.方法 择期全麻下心脏瓣膜置换术患者30例,性别不限,年龄50 - 64岁,体重50 - 75 kg,ASA分级Ⅲ级,采用随机数字表法将其分成2组（n=15）：对照组（C组）和葛根素组（P组）.P组于切皮即刻经30 min静脉输注葛根素400 mg,C组给予等容量5％葡萄糖氯化钠注射液.于麻醉诱导前（T0）、CPB 30 min（T1）、主动脉开放即刻（L）和CPB后6 h（T3）、12 h（T4）、24 h（T5）时取颈内静脉球部血样,测定血浆神经元特异性烯醇化酶（NSE）和S-100β蛋白浓度.于术前1 d及术后7d测定脑事件相关电位P300潜伏期和振幅,记录简易精神状态检查量表（MMSE）评分,术后MMSE评分低于术前2分以上或评分≤24分为术后认知功能障碍的诊断标准.结果 与 C组比较,P组T1-5时血浆NSE和S-100β蛋白浓度降低,术后7d时P300潜伏期缩短,振幅升高,术后认知功能障发生率降低（P＜0.05） 结论 葛根素可预防CPB心脏直视术患者脑损伤.Objective To evaluate the efficacy of puerarin for prevention of brain injury in the patients undergoing open heart surgery under cardiopulmonary bypass （CPB）.Methods Thirty ASA physical status Ⅲ patients of both sexes,aged 50-64 yr,weighing 50-75 kg,scheduled for elective cardiac valve replacement under general anesthesia,were randomly divided into 2 groups （n =15 each） using a random number table：control group（group C） and puerarin group （group P）.Puerarin 400 mg was infused intravenously over 30 min immediately at skin incision in group P and the equal volume of 5％ glucose-sodium chloride injection was given in group C.Before induction of anesthesia （T0）,at 30 min of CPB （T1）,immediately after aortic unclamping （T2）,and at 6,12 and 24 h after termination of CPB （T3.5）,blood samples were collected from the jugular venous bulb for determination of the plasma concentration of neuron-specific enolase （NSE） and S-100 β protein.P300 eventrelated potential latency and amplitude were determined and cognitive function was assessed by Mini-Mental State Examination （MMSE） score at 1 day before surgery and 7 days after surgery.The patients were diagnosed as having post-operative cognitive dysfunction when MMSE score before surgery-MMSE score after surgery ≥ 2,or when M MSE score≤ 24.Results Compared with group C,the concentrations of plasma NSE and S-100 β protein were significantly decreased at T15,and P300 event-related potential latency was shortened,P300 event-related potential amplitude was increased,and the incidence of postoperative cognitive dysfunction was decreased at 7 days after operation in group P.Conclusion Puerarin can prevent the brain injury in the patients undergoing open heart surgery under CPB.

关 键 词：葛根素 心肺转流术 心脏瓣膜假体植入 脑损伤 

分 类 号：R614[医药卫生—麻醉学]