七氟醚预处理对心肺转流下心脏瓣膜置换术患者外周血SOD、MDA及白细胞NF-κB的影响  

Effects of sevoflurane preconditioning on SOD,MDA and NF-κB in peripheral blood of patients undergoing cardiac valve replacement under cardiopulmonary bypass

作　　者：朱辉[1] 侯丽娟[1] 蔡强[1] 韩红[1] 王丽阳[1] 梅欢[1] 张茜[1] 吕昆阳 李莲[2] 

机构地区：[1]湖北医药学院附属东风医院麻醉科,湖北省十堰市442008 [2]湖北医药学院附属人民医院检验部

出　　处：《江苏医药》2017年第9期616-619,共4页Jiangsu Medical Journal

基　　金：湖北省科技厅自然科学基金(2012FFC004);湖北省教育厅青年基金(Q20122404);十堰市科学技术研究与开发项目(ZD2011033)

摘　　要：目的观察七氟醚预处理对心肺转流(CPB)下心脏瓣膜置换术(CVR)患者外周血超氧化物歧化酶(SOD)、丙二醛(MDA)浓度及白细胞NF-κB的影响。方法择期行CVR患者60例随机均分为七氟醚预处理组(S组)和对照组(C组)。S组在麻醉诱导后吸入1.0%七氟醚30min后洗脱,至CPB开始时使呼气末七氟醚浓度均<0.1%。以咪达唑仑、丙泊酚、舒芬太尼和罗库溴铵维持麻醉。C组不吸入七氟醚,其他用药与S组相同。分别于麻醉诱导前(T0)及主动脉开放30min(T1)、1h(T2)、2h(T3)和6h(T4)采集桡动脉血,检测血浆SOD活性、MDA含量及白细胞NF-κB活性。结果两组患者T1~T4时的SOD活性较T0降低(P<0.05),MDA含量较T0升高(P<0.05);S组T1~T4时的SOD活性高于C组,而MDA含量和NF-κB活性均低于C组(P<0.05)。结论七氟醚预处理能减轻CVR患者心肌细胞氧化应激损伤,发挥心肌保护作用。Objective To investigate the effects of sevoflurane preconditioning on superoxide dismutase（SOD）,malondialdehyde（MDA）and nuclear factor-kappa B（NF-κB）in peripheral blood in the patients undergoing cardiac valve replacement（CVR）under cardiopulmonary bypass（CPB）.Methods Sixty patients undergoing CVR were equally randomized into two groups.Group S was treated with sevoflurane preconditioning,in which 1.0% sevoflurane was inhaled for 30 minutes soon after anesthesia induction.Sevoflurane was not given in group C.Anesthesia in both groups was maintained with propofol,midazolam,sufentanil and rocuronium.The artery blood samples were collected for the detection of plasma SOD,MDA and NF-κB before anesthesia（T0）and at 30minutes（T1）,60 minutes（T2）,120 minutes（T3）and 360 minutes（T4）after aortic unclamping.Results Compared with T0,the activity of SOD was decreased and MDA was increased at T1-T4 in two groups（P〈0.05）.At T1-T4,the activity of SOD was higher,but MDA and NF-κB were lower,in group S than those in group C（P〈0.05）.Conclusion Sevoflurane preconditioning has myocardial protective effect by alleviating the oxidative stress injury of myocardial cells in the patients undergoing CVR under CPB.

关 键 词：七氟醚预处理 心脏瓣膜置换术 心肺转流 氧化应激损伤 

分 类 号：R614[医药卫生—麻醉学]