乌司他丁对幕上肿瘤切除术患者血清S100β蛋白和神经原特异性烯醇化酶的影响  

Effect of ulinastatin on serum concentration of S100βprotein and NSE in patients undergoing supratentorial tumor resection

作　　者：刘世乐[1] 邢祖民[1] 李凤仙[2] 袁柳青[2] 许平[2] 徐世元[2] 

机构地区：[1]佛山市顺德区第一人民医院麻醉科,528300 [2]南方医科大学珠江医院麻醉科

出　　处：《临床麻醉学杂志》2016年第4期325-327,共3页Journal of Clinical Anesthesiology

基　　金：2015年广东省自然科学基金(2015A030313258)

摘　　要：目的观测乌司他丁对幕上肿瘤切除术患者血清S100β蛋白和神经原特异性烯醇化酶（NSE）浓度的影响。方法择期行幕上肿瘤切除术患者24例,年龄18~65岁。随机数字表法分为两组,每组12例。U组在切皮时予2kU/kg乌司他丁静脉推注,随后予1kU·kg-1·h-1泵注至术毕。A组于相同时点输入等量生理盐水。分别于全麻诱导前（T1）、切皮前（T2）、切硬脑膜后1h（T3）、缝硬脑膜（T4）、手术结束（T5）及术后24h（T6）采集颈内静脉球部血,ELISA法测定血清S100β和NSE浓度。结果 T3~T6时两组患者血清S100β蛋白和NSE浓度均明显高于T1时（P〈0.01）。T3~T5时U组患者血清S100β蛋白和NSE浓度明显低于A组（P〈0.01）。结论预防性输注与术中持续应用乌司他丁可降低幕上肿瘤切除术患者血清S100β蛋白和NSE浓度,减轻脑组织损伤。Objective To observe the serum concentration of S100βprotein（S100β）and neuron specific enolase（NSE）in patients undergoing supratentorial tumor resection with ulinastatin treatment.Methods Twenty-four patients with supratentorial tumor resection,aged 18-65 years,ASA ⅠorⅡ,were randomly divided into the control group（group A,n=12）and ulinastatin group（group U,n=12）.Patients in group U received ulinastatin（2kU/kg）at the beginning of the surgery,with the continuous dose of 1kU·kg-1·h-1 till the end of the operation.Group A received equivalent volume of saline solution as the vehicle control.Blood samples were taken from the artery and jugular venous bulb before induction of anesthesia（T1）,skin incision（T2）,1hafter dura openning（T3）,at the closure of dura（T4）,at the end of operation（T5）and 24 hafter operation（T6）to analyze the concentration of S100βand NSE.The concentration of S100βand NSE were determined by ELISA.Results The concentration of serum S100βand NSE increased more significantly higher at T3-T6 in group A than group U（P〈0.01）.The concentration of serum S100βand NSE in group U were lower than those in group A at T3-T5（P〈0.01）.Conclusion Ulinastatin reduces the concentration of serum S100βand NSE during surgery,indicating it alleviates brain injury during supratentorial tumor resection.

关 键 词：幕上肿瘤切除术 乌司他丁 S100Β蛋白 神经原特异性烯醇化酶 

分 类 号：R614[医药卫生—麻醉学] R739.4[医药卫生—外科学]