丙泊酚联合雷米芬太尼对颅内动脉瘤夹闭术患者血浆内皮素和一氧化氮水平的影响  

Effects of propofol combined with remifentanil intravenous anesthesia on plasma levels of endothelin and nitric oxide in patients undergoing intracranial aneurysm clipping operation

作　　者：陈莺[1] 武勇[1] 赵志斌[1] CHEN Ying;WU Yong;ZHAO Zhibin.(Department of Anesthesiology, First People＇s Hospital of Lianyungang, Lianyungang 222002, CHIN)

机构地区：[1]连云港市第一人民医院麻醉科,江苏222002

出　　处：《江苏医药》2018年第4期391-393,共3页Jiangsu Medical Journal

基　　金：连云港市卫生局科研课题(1218)

摘　　要：目的探讨丙泊酚联合雷米芬太尼静脉麻醉对颅内动脉瘤夹闭术患者血浆内皮素(ET)和一氧化氮(NO)水平的影响。方法 64例行颅内动脉瘤夹闭术的患者随机均分为两组,分别采用丙泊酚联合雷米芬太尼静脉麻醉(试验组)和丙泊酚联合异氟醚复合麻醉(对照组)。在麻醉前(T0)、夹闭动脉瘤时(T1)、夹闭后30min(T2)和术后2h(T3)测定两组患者血浆ET和NO水平。结果两组T1、T2时ET和NO水平均较T0时下降(P<0.05)。T3时试验组ET水平低于T0时(P<0.05),且低于对照组(P<0.05)。与T0时相比,对照组T1、T2、T3时NO/ET比值均下降(P<0.01),试验组仅在T2时下降(P<0.01)。试验组T1、T3时的NO/ET比值高于对照组(P<0.05)。结论两种麻醉方法均能降低颅内动脉瘤夹闭术患者术中血浆ET和NO的水平。丙泊酚联合雷米芬太尼静脉麻醉抑制血浆ET更明显,有利于NO/ET平衡,产生脑保护作用。Objective To investigate the effects of propofol combined with remifentanil intravenous anesthesia on plasma levels of endothelin（ET） and nitric oxide （NO） in the patients undergoing intracranial aneurysm clipping operation. Methods Sixty-four patients undergoing intracranial aneurysm clipping operation were randomly and equally divided into two groups of A （received propofol combined with remifentanil intravenous anesthesia） and B （received propofol combined with isoflurane anesthesia）. Plasma levels of ET and NO were detected before anesthesia （TO） ,immediately after aneurysm clipping（T1）,at 30 minutes after clipping（T3） and 2 hours after the operation（T3）. Results Plasma levels of ET and NO were lower at T1 and T2 than those at TO in two groups（P〈0. 05）. Plasma ET level was lower at T3 than that at TO in group A（P〈0. 05） ,which was lower in group A than that in group B at T3 （P〈0. 05）. Compared with TO, the ratio of NO to ET was decreased at T1 to T3 in group B and at T2 in group A（P〈0. 01） ,which was higher in group A than that in group B at T1 and T3 （P〈0. 05）. Conclusion The two anesthesia methods can both reduce plasma levels of ET and NO in the patients undergoing intracranial aneurysm clipping operation. Propofol combined with remifentanil intravenous anesthesia shows more obvious inhibition of plasma ET level, which is beneficial to the balance of the ratio of NO to ET and brain protection.

关 键 词：丙泊酚 雷米芬太尼 颅内动脉瘤夹闭术 内皮素 一氧化氮 

分 类 号：R614[医药卫生—麻醉学]