乌司他丁联合右美托咪定对幕上肿瘤切除术患者氧化应激及S100β和NSE的影响  

Effect of ulinastatin combined with dexmedetomidine on oxidative stress,S100β and NSE in patients with supratentorial tumor resection

作　　者：陈元良[1] 徐丽丽 张磊[1] 乐新会[1] 吕华燕 CHEN Yuan-liang;XU Li-li;ZHANG Lei;et al(Department of anesthesiology, Central Hospital of Jinhua, Jinhua, Zhejiang 321000, China)

机构地区：[1]金华市中心医院麻醉科,浙江金华321000 [2]浙江中医药大学附属第二医院(浙江省新华医院)麻醉科,浙江杭州310005

出　　处：《中华全科医学》2018年第1期41-43,共3页Chinese Journal of General Practice

基　　金：浙江省自然科学基金(2014ZDA029)

摘　　要：目的探讨乌司他丁联合右美托咪定对幕上肿瘤切除术患者氧化应激及S100β蛋白(S100β)、神经特异性烯醇化酶(NSE)的影响。方法选取择期行幕上肿瘤切除术患者60例,随机对照表法分为观察组和对照组,各30例。对照组切皮时泵注乌司他丁2 000 U/kg,随后以1 000 U/(kg·h)的剂量静脉泵注至术毕,观察组在对照组的基础上同时输注右美托咪定,切皮时泵注右美托咪定1μg/kg,随后以0.5μg/(kg·h)的剂量静脉泵注至术毕前30 min。分别于诱导前(T0)、切皮前(T1)、切硬膜后(T2)、术毕(T3)、术后24 h(T4)检测2组患者颈内静脉球部血清氧化应激指标超氧化物歧化酶(SOD)、丙二醛(MDA)及S100β和NSE水平,并进行比较。结果 2组患者T2、T3、T4时氧化应激指标SOD水平均较T0时明显降低(P<0.05),T2、T3、T4时MDA水平均较T0时明显升高(P<0.05),但对照组SOD下降及MDA升高更显著(P<0.05);2组T2、T3、T4时S100β、NSE水平均较T0时明显升高(P<0.05),但对照组S100β、NSE水平升高更显著(P<0.05)。结论乌司他丁联合右美托咪定可明显减轻幕上肿瘤切除术对患者SOD活性的抑制,减少MDA水平,减轻氧化应激损伤,同时对于S100β、NSE水平的升高有一定的抑制作用,增强脑保护效果。Objective To investigate the effect of ulinastatin combined with dexmedetomidine on oxidative stress, S100β and NSE in patients with supratentorial tumor resection. Methods A total of 60 patients with supratentorial tumor resection were randomly divided into observation group （30 cases ） and control group （30 cases ）. The patients of the control group received ulinastatin （2 000 U/kg） at time of skin incision, then received dose of 1 000 U/（ kg · h） until the end of the operation. On the basis of control group, the patients of observation group received dexmedetomidine at the same time,dose of 1μg/kg at time of skin incision, then received dose of 0.5 μg/（kg·h） until 30 min before the end of the operation. SOD, MDA, S100β and NSE of jugular venous bulb serum were tested and compared in 2 groups at the time of before induction （TO） , before skin incision, after cutting epidural, end of operation and 24 h after operation. Results Compared with TO, the level of SOD decreased significantly at T2, T3 and T4 in 2 groups （P 〈 0.05 ） , the level of MDA increased significantly at T2, T3 and T4 in 2 groups （P 〈 0.05）, but the changes of observation group was significant smaller （P 〈 0.05 ）. Compared with TO ,the level of S10013and NSE increased significantly at T2, T3 and T4 in 2 groups （P 〈 0.05） , but the changes of observation group was significant smaller （P 〈 0.05）. Conclusion Ulinastatin combined with dexmedetomidine can obviously reduce the inhibition of SOD, MDA level and oxidative stress damage. At the same time, reduce S100β and NSE, boost brain protection in patients with supratentorial tumor resection.

关 键 词：乌司他丁 右美托咪定 幕上肿瘤切除术 氧化应激 S100Β蛋白 神经特异性烯醇化酶 

分 类 号：R739.41[医药卫生—肿瘤] R614[医药卫生—临床医学]