异丙酚与安氟醚或七氟醚静吸复合麻醉对心肌酶的影响  

Effect of propofol-enflurane or propofol-sevoflurane combining anaesthesia on myocardial enzymes

作　　者：冯春生[1] 赵恒兰[1] 王凡[1] 裴纪东 马辉[3] 

机构地区：[1]吉林大学第一医院麻醉科,吉林长春130021 [2]吉林省白城市中心医院麻醉科 [3]吉林省永吉县医院麻醉科

出　　处：《吉林大学学报（医学版）》2002年第5期529-532,共4页Journal of Jilin University：Medicine Edition

摘　　要：目的 :观察异丙酚与安氟醚或七氟醚静吸复合麻醉对心肌酶的影响。方法 :32例择期非心脏手术的全麻病人 ,随机分为 4组 (每组 8例 ) ,分别给予安氟醚麻醉 ( A组 )、七氟醚麻醉 ( B组 )、异丙酚 -安氟醚麻醉 ( C组 )、异丙酚 -七氟醚麻醉 ( D组 )。其中 A、B组为对照组 ,C、D组为观察组。分别于麻醉前、麻醉诱导后 2 h和术后 3d采集静脉血测血清磷酸肌酸激酶 ( CK)及其同功酶 ( CK-MB)、天门冬氨酸氨基转移酶 ( AST)、乳酸脱氢酶 ( LDH)、α-羟丁酸脱氢酶 ( HBDH)。结果 :麻醉诱导后 2 h,A组 CK、CK- MB值、LDH及 HBDH值升高 ,与麻醉前比较差异有显著性 ( P<0 .0 1或P<0 .0 5 ) ;B组 CK和 CK- MB值升高 ,与麻醉前比较差异有显著性 ( P<0 .0 5或P<0 .0 1 )。术后3d,A、B两组 CK值升高 ,与麻醉前和麻醉诱导后 2 h比较差异有显著性 ( P<0 .0 1或 P<0 .0 5 ) ,AST值升高 ,与麻醉前比较差异有显著性 ( P<0 .0 1或 P<0 .0 5 )。而且 A、B两组相比较 ,A组的CK、LDH值升高幅度明显大于 B组 ( P<0 .0 5 )。 C、D两组仅 CK值在术后 3d与麻醉前比较差异均有显著性 ( P<0 .0 1 ) ,但其升高幅度均明显低于 A、B两组的同时值 ( P<0 .0 1 ) ,其余各项心肌酶的变化在麻醉诱导后 2 h及术后 3d差异均无显著性 ( P>0 .0 5 )。Objective : To investigate the effect of propofol enflurane or propofol sevoflurane combinng anaesthesia on myocardial enzymes in sera of patients. Methods: Thirty two adult patients receiving non cardiac surgery under general anaesthesia were divided into Group A,( n =8),group B ( n =8),group C ( n =8) and group D ( n =8) given enflurane,sevoflurane or propofold enflurant or propofol sevoflurane,respectively. Group A and group B were control and group C and D were observed. The serum specimens were taken from all patients before anesthesia 2 h after anesthesia induction and 3 d after operation, respectively,to measure enzymatic activities of CK,CK MB,AST LDH and HBDH.Results:Activities of enzyme CK, CK MB,AST,LDH and HBDH from sera of patients in group A and CK and CK MB in group B were increased more signifcantly 2 h after anesthesia induction than those before anesthesia ( P <0 01 or P <0 05) . The enzymatic activities of CK in both group A and B were increased more significantly 3 d after operation than those before anesthesia 2 h after induction ( P <0 01 or P <0 05) and AST activity in both gropu A and B 3 d after operation was increased more significantly than that of before aneshensia only ( P <0 01 or P <0 05). Furthermore, activity of CK and LDH in group A was remarkably increased in comparison with group B ( P <0 05) . The enzymatic activitie of CK in group C and D were higher 3 d after operation than that before anesthesia only,but lower than those in both group A and B at the same time points ( P <0 01). In comparision with group C, the activities of CK,CK MB,HBDH and LDH 2 h after induction and CK only 3 d after operation in group A were higher than those before anesthesion ( P <0 01 or P <0 05). Activity of CK 2 h after induction and 3 d after operation or CK MB 2 h after induction in group B were higher than those in group D. Conclusion: Both enflurane especially sevoflurane can increase activities of myocardial enzymes in sera of patients,

关 键 词：异丙酚 安氟醚 七氟醚 静吸复合麻醉 心肌酶 

分 类 号：R971.2[医药卫生—药品] R614[医药卫生—药学]