快通道心脏麻醉对心脏手术患者心肌氧化损伤、炎症反应以及神经相关肽的影响研究  

Effects of Fast Channel Cardiac Anesthesia on Myocardial Oxidative Damage,Inflammation and Neuropeptide in Cardiac Surgery Patients

作　　者：周佳慧 乔领 王志强 白栓成[1] ZHOU Jiahui;QIAO Ling;WANG Zhiqiang;BAI Shuancheng(Department of Anesthesiology,Baotou Central Hospital,Baotou,Inner Mongolia Autonomous Region,014040 China)

机构地区：[1]内蒙古包头市中心医院麻醉科,内蒙古包头014040

出　　处：《世界复合医学》2023年第3期9-13,共5页World Journal of Complex Medicine

基　　金：包头市科技项目(2019Z3009-4)。

摘　　要：目的研究快通道心脏麻醉对心脏手术患者心肌氧化损伤、炎症反应以及神经相关肽的影响。方法选择2020年5月—2022年3月到内蒙古包头市中心医院接受心脏手术的患者150例作为观察对象,按照麻醉方式不同,分为研究组(快速通道心脏麻醉)和对照组(常规麻醉),各75例,分析麻醉对患者各项指标产生的影响。结果两组患者T1时的收缩压、舒张压、心率水平比较,差异无统计学意义(P>0.05)。研究组T2、T3、T4时的收缩压、舒张压、心率水平均低于对照组,差异有统计学意义(P<0.05)。两组麻醉前、术后5 d的SOD、MDA水平比较,差异无统计学意义(P>0.05);研究组主动脉开放后60 min与术后1 d的SOD、MDA水平均明显优于对照组,差异有统计学意义(P<0.05)。研究组动脉开放后180 min神经相关肽和炎性因子指标均低于对照组,差异有统计学意义(P<0.05)。研究组患者T2、T3、T4、T5时的cTnI含量分别为(1.83±0.23)、(2.60±0.34)、(3.55±0.52)、(2.61±0.28)ng/mL均低于对照组的(2.77±0.34)、(3.34±0.38)、(5.17±0.61)、(4.01±0.50)ng/mL,差异有统计学意义(t=19.832、12.568、17.503、21.157,P<0.05)。结论快通道心脏麻醉方式作为心脏手术中较为理想的一种麻醉方式,可对心肌细胞保护,提升麻醉效果,降低线粒体氧化应激,改善机体神经功能和缓解机体的炎症反应。Objective To investigate the effects of fast channel cardiac anesthesia on myocardial oxidative damage,inflammation and neuropeptide in patients undergoing cardiac surgery.Methods 150 patients who underwent cardiac surgery at Baotou Central Hospital in Inner Mongolia from May 2020 to March 2022 were selected as observation subjects.They were divided into a study group(fast track cardiac anesthesia)and a control group(conventional anesthesia)according to different anesthesia methods,with 75 patients in each group.The impact of anesthesia on various indicators of patients was analyzed.Results There was no statistically significant difference in systolic blood pressure,diastolic blood pressure,and heart rate levels between the two groups of patients at T1(P>0.05).The levels of systolic blood pressure,diastolic blood pressure,and heart rate in the study group at T2,T3,and T4 were lower than those in the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference in the levels of SOD and MDA between the two groups before anesthesia and 5 days after surgery(P>0.05).The levels of SOD and MDA in the study group were significantly higher than those in the control group 60 minutes after aortic opening and 1 day after surgery,the difference was statistically significant(P<0.05).The neuropeptide and inflammatory factor indicators in the study group were lower than those in the control group 180 minutes after arterial opening,the difference was statistically significant(P<0.05).The cTnI levels of patients in the study group at T2,T3,T4,and T5 were(1.83±0.23)ng/mL,(2.60±0.34)ng/mL,(3.55±0.52)ng/mL,and(2.61±0.28)ng/mL,respectively,lower than those in the control group(2.77±0.34)ng/mL,(3.34±0.38)ng/mL,(5.17±0.61)ng/mL,and(4.01±0.50)ng/mL,the difference was statistically significant(t=19.832,12.568,17.503,21.157,P<0.05).Conclusion Fast channel cardiac anesthesia,as an ideal anesthesia method in cardiac surgery,can protect myocardial cells,improve anesthesia effectiv

关 键 词：快通道心脏麻醉 心脏手术 心肌氧化损伤 炎症反应 神经相关肽 

分 类 号：R4[医药卫生—临床医学]