帕瑞昔布钠对脑肿瘤切除术患者炎症反应的影响及脑保护作用  

Effects of parecoxibsodium on inflammatory response and its neuroprotection in patients undergoing brain tumor surgery

作　　者：于玉娟[1] 高成杰[2] 王晓鹏[1] 李波[2] 

机构地区：[1]锦州医科大学济南军区总医院研究生培养基地,山东济南250031 [2]济南军区总医院麻醉科,山东济南250031

出　　处：《山东大学学报（医学版）》2016年第6期65-68,86,共5页Journal of Shandong University:Health Sciences

摘　　要：目的观察帕瑞昔布钠对脑肿瘤切除术患者血清肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）、神经元特异性烯醇化酶（NSE）与S100β蛋白的影响,探讨其脑保护作用。方法将40例择期全麻下开颅脑肿瘤切除术患者随机分为帕瑞昔布钠组和空白对照组,每组20例。帕瑞昔布钠组麻醉诱导前和诱导后12 h分别静注帕瑞昔布钠40 mg（溶于5 mL生理盐水）,空白对照组相同方式静注生理盐水5 mL。检测两组患者入室后（T_0）、切除肿瘤时（T_1）、手术结束时（T_2）、术后6 h（T_3）、术后24 h（T_4）血清TNF-α、IL-1β、NSE及S100β蛋白的浓度。结果与空白对照组相比,帕瑞昔布钠组患者T_1~T_4时血清TNF-α、IL-1β、NSE和S100β蛋白水平明显降低（P〈0.01）。与T_0时比较,两组患者T_1~T_4时血清TNF-α、IL-1β、NSE和S100β蛋白水平明显增高（P〈0.01）。结论帕瑞昔布钠可抑制脑肿瘤切除术患者TNF-α、IL-1β的表达,降低血清中NSE和S100β蛋白水平,其脑保护作用可能与抑制炎症反应有关。Objective To observe the effects of parecoxibsodium on serum levels of tumor necrosis factor-α（ TNF-α）,interleukin 1β（ IL-1β）,neuron-specific enolase（ NSE） and S100β protein in patients undergoing brain tumor surgery,and to investigate its neuroprotection effects. Methods Forty patients undergoing brain tumor surgery under general anesthesia were randomly divided into the parecoxibsodium group and the control group,twenty in each group. The parecoxibsodium group was injected intravenously 40 mg parecoxibsodium（ dissolved in 5 mL saline solution） before and 12 hours after the anesthesia induction,the control group received 5 mL saline solution in the same way. The serum levels of TNF-α,IL-1β,NSE and S100β protein were measured before anesthesia induction（ T_0）,after removing the tumor（ T_1）,the completion of surgery（ T_2）,6 h after surgery（ T_3） and 24 h after surgery（ T_4）. Results Compared with the control group,the levels of TNF-α,IL-1β,NSE and S100β protein in the parecoxibsodium group obviously decreased at the time points of T_1-T_4（ P〈0. 01）. Compared with the time point of T_0,the levels of TNF-α,IL-1β,NSE and S100β protein in two groups obviously increased at the time points of T_1-T_4（ P〈0. 01）. Conclusion Parecoxibsodium can inhibit the expressions of TNF-α,IL-1β and decrease the levels of NSE and S100β protein in the serum,and it can provide neuroprotection effects through alleviating the inflammation response during brain tumor surgery.

关 键 词：帕瑞昔布钠 脑保护 肿瘤坏死因子-α 白细胞介素-1β 神经元特异性烯醇化酶 S100Β蛋白 

分 类 号：R971[医药卫生—药品]