右美托咪定复合芬太尼及七氟烷对幕上脑肿瘤患者血清NSE、S-100β、SOD和MDA含量及脑氧供需平衡的影响  

Effect of Dexmedetomidine Combined with Fentanyl and Sevoflurane on Concentration of Serum NSE,S-100β,SOD and MDA and Cerebral Oxygen Balance in Patients with Supratentorial Tumor Resection at Perioperation

作　　者：谢小娟[1] 李前辉[1] 宋绍团[1] 郭孝龙[2] 

机构地区：[1]河南科技大学第一附属医院新区医院麻醉科,洛阳471300 [2]河南科技大学第一附属医院新区医院神经外科,洛阳471300

出　　处：《华中科技大学学报（医学版）》2017年第1期76-79,93,共5页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

摘　　要：目的观察右美托咪定复合芬太尼及七氟烷对幕上脑肿瘤患者血清神经原特异性烯醇化酶(NSE)、S-100β蛋白,超氧化物歧化酶(SOD),以及丙二醛(MDA)含量及脑氧供需平衡的影响。方法选择幕上脑肿瘤患者70例,随机分为实验组和对照组,实验组在麻醉诱导前给予右美托咪定,对照组给予等量生理盐水,其他处理相同。于全麻诱导前(T1)、气管插管(T2)、切开硬脑膜(T3)、切开硬脑膜1 h后(T4)、硬脑膜缝合时(T5)、术后24 h(T6)6个时间点检测动-静脉血氧含量差(Ca-jvO_2)、颈内静脉球部血氧饱和度(SjvO_2),脑氧摄取率(CERO_2),血清NSE、S-100β、SOD和MDA含量。结果针对Ca-jvO_2及CERO_2指标,实验组在T3、T4、T5及T6时点相比对照组均降低(均P<0.05)。针对SjvO_2指标,实验组在T3、T4、T5及T6时点相比对照组均升高(均P<0.05)。针对SOD含量,实验组在各时间点相比对照组均升高(均P<0.05)。针对MDA含量,实验组在T3、T4、T5及T6时点相比对照组均降低(均P<0.05)。针对S-100β含量,实验组在T2、T3、T4、T5及T6时点相比对照组均降低(均P<0.05)。针对NSE含量,实验组在T3、T4、T5及T6时点相比对照组均降低(均P<0.05)。结论右美托咪定可显著改善脑氧供需平衡,下调颅内自由基含量,降低多种脑损伤的特异性蛋白含量,从而实现脑保护作用。Objective To investigate the effect of dexmedetomidine combined with tentanyl and sevoflurane on the concentration of serum NSE,S-100β,SOD and MDA and cerebral oxygen balance in the patients with supratentorial tumor resection at perioperation.Methods Totally,70 patients with supratentorial tumor were randomly divided into 2 groups：experimental group and control group.The experimental group was treated with dexmedetomidine,and control group was given normal saline.Arteriovenous oxygen content difference（Ca-jvO2）,jugular bulb venous oxygen saturation（SjvO2）,cerebral extraction of oxygen（CERO2）,serum neuron specific enolase（NSE） and S-100β protein,superoxide dismutase（SOD）,and malonaldehyde（MDA）were recorded before anaesthesia（T1）,at tracheal intubation of anesthesia induction（T2）,dura mater incision（T3）,1 h after dura mater incision（T4）,at dura mater suture（T5）,24 h after surgery（T6）.Results Compared with the control group,（1）Ca-jvO2 and CERO2 were decreased at T3,T4,T5 and T6（P〈0.05）;（2）SjvO2 was increased at T3,T4,T5 and T6（P〈0.05）;（3）SOD was increased at all time points（P〈0.05）;（4）MDA was decreased at T3,T4,T5 and T6（P〈0.05）;（5）S-100βwas decreased at T2,T3,T4,T5 and T6（P〈0.05）;（6）NSE was decreased at T3,T4,T5 and T6（P〈0.05）.Conclusion The dexmedetomidine can protect brain by improving cerebral oxygen balance,reducing the content of free radicals and specific protein of brain damage.

关 键 词：右美托咪定 幕上脑肿瘤 脑氧供需平衡 神经原特异性烯醇化酶 S-100Β蛋白 超氧化物歧化酶 丙二醛 

分 类 号：R971[医药卫生—药品]