复方甘草酸苷对肢体缺血再灌注损伤影响的临床观察  

T he Effects of Compound Glycyrrhizin Glucoside on the Limb Ischemia Reperfusion Injury in Humans

作　　者：卢卫忠[1] 刘正敏[1] 胡志芬[1] 曹洪辉[1] 冉金伟[1] 陈忠余[1] 傅洪[1] 

机构地区：[1]重庆市中医院,重庆400021

出　　处：《中国中医急症》2015年第7期1159-1161,1192,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：重庆市卫生局中医药科技项目(2013-2-156)

摘　　要：目的观察复方甘草酸苷对肢体缺血再灌注损伤的作用,探索延长肢体使用止血带的最大限度时间。方法 48例患者随机分为常规使用止血带组(A组)、复方甘草酸苷组(B组)、复方甘草酸苷处理后止血带延长0.5 h组(C组)和复方甘草酸苷处理后止血带延长1.0 h组(D组)各12例。除A组外,各组给予复方甘草酸苷术前静滴。观察止血带加压前、再灌注0.5 h、1.5 h、3 h、24 h和72 h分别检测血清丙二醛(MDA)、肌酸磷酸激酶(CPK)、谷草转氨酶(GOT)和乳酸脱氢酶(LDH)的含量以及超氧化物歧化酶(SOD)活性。结果随着止血带加压肢体后再灌注时间的延长,血中MDA、CKP、GOT和LDH逐渐上升,SOD活性逐渐降低。在A组,与缺血前(止血带加压前)比较,肢体缺血再灌注(手术结束完全松止血带)后30 min、90 min、3 h、24 h和72 h,血清MDA、CPK、GOT和LDH含量升高,24 h达到高峰,至72 h降至再灌注后3 h的水平;而SOD活性呈进行性下降,24 h降至最低,至72 h恢复至再灌注后3 h的水平。B组和C组再灌注后各同时相点内,血清MDA、CPK、GOT和LDH含量明显低于A组(均P<0.05),SOD活性明显高于A组(均P<0.05)。与A组相比,再灌注后3 h、24 h和72 h,D组血中MDA、CKP、GOT和LDH含量以及SOD活性无明显差别(均P>0.05)。与B组相比,再灌注后3 h、24 h和72 h,C组和D组的血清MDA、CPK、GOT和LDH含量明显升高(均P<0.05),SOD活性降低(均P<0.05)。与C组相比,再灌注后3 h、24 h和72 h,D组的血清MDA、CPK、GOT和LDH含量明显升高(均P<0.05),SOD活性降低(均P<0.05)。结论复方甘草酸苷对肢体缺血再灌注损伤有保护作用,通过其保护作用,可以将肢体使用止血带时间从常规的1.5 h延长0.5 h和1.0 h,最佳延长使用0.5 h。Objective： To observe clinical effects of compound glycyrrhizin glucoside on the limb ischemia reperfusion injury and explore prolong maximum time of limb by using a tourniquet. Methods： 48 patients under- going operations on the extremities with the application of a pneumatic tourniquet were divided randomly into four groups： the routine use of a tourniquet group （group A）, the compound glycyrrhizin glucoside group （group B）, the compound glycyrrhizin glucoside tourniquet extending 0.5 hours group after treatment （group C）,as well as the compound glycyrrhizin glucoside tourniquet extending 1.0 hours group after treatment （group D）. Compound gly- cyrrhizin glucoside 20 ml to join saline 100 ml intravenous dripped 10 minutes before the onset of ischemic oper- ation. The contents of serum MDA, CPK, GOT and LDH, as well as SOD activity were measured respectively be- fore the extremities by application of a pneumatic tourniquet,0.5 h, 1.5 h,3 h,2g h and 72 h after reperfusion. Results： In group B and group C within each phase at the same time point after reperfusion, serum MDA, CPK, LDH and GOT content were lower than those in group A;SOD activity was significantly higher in group A. Com- pared with group A,3 hours 24 hours and 72 hours after reperfusion,there were no significant differences in serum MDA,CKP,GOT and LDH contents and SOD activity in group D. Compared with group B, 3 hours,24 hours and 72 hours after reperfusion,the serum MDA,CPK and LDH and GOT contents increased,while SOD ac-tivity decreased significantly in group C and group D. Compared with group C, 3 hours, 24 hours and 72 hours af- ter reperfusion,there were significant increases of serum MDA,CPK and LDH and GOT contents,while SOD ac- tivity decreased significantly in group D. Coneluslon： Compound glycyrrhizic acid glycosides has protective effect on the limb ischemia reperfusion injury ,and with its protection effect,the regular time 1.5 hours of limb using a tourniquet can be prolonged by 0.5 hours and 1.0 hours, and b

关 键 词：缺血再灌注损伤 止血带 甘草酸苷 四肢 自由基 

分 类 号：R274[医药卫生—中医骨伤科学]