丙泊酚对成年癫痫患者大脑边缘系统脑电的影响  

Effect of propofol on electroencephalography waves of brain limbic system in adult patients with epilepsy

作　　者：张蕊[1] 付君祚 龚德山 黄青青 陆月梅 郭辉[3] 谢致 ZHANG Rui;FU Junzuo;GONG Deshan(Department of Anesthesiology,Shanghai Neueomedical Center,Shanghai Clinical Medical college of Qingdao University,Shanghai(200331),Shanghai,China)

机构地区：[1]上海德济医院,青岛大学上海临床医学院麻醉科,上海200331 [2]上海市第一人民医院麻醉科 [3]上海德济医院,青岛大学上海临床医学院神经外科 [4]上海德济医院,青岛大学上海临床医学院神经电生理中心

出　　处：《癫痫与神经电生理学杂志》2024年第3期141-148,共8页Journal of Epileptology and Electroneurophysiology(China)

基　　金：上海市卫生健康委员会科研课题(202040069)。

摘　　要：目的观察不同效应室浓度丙泊酚对成年癫痫患者大脑边缘系统立体定向脑电图(SEEG)的影响。方法选取青岛大学上海临床医学院癫痫外科2021年1月至2022年12月收治的行ROSA机器人辅助颅内电极植入术(植入电极位于大脑边缘系统)后拔除电极手术治疗的成年癫痫患者14例。根据植入大脑边缘系统的电极位于左侧或右侧大脑,将患者分为A组(左侧)和B组(右侧),每组各7例。随着丙泊酚效应室浓度增加,分别记录5个浓度组,即D1组(0μg/mL)、D2组(2μg/mL)、D3组(3μg/mL)、D4组(4μg/mL)和D5组(5μg/mL)。观察不同效应室浓度丙泊酚对左、右两侧大脑边缘系统脑电图的影响。结果在A组内,D2、D3、D4、D5组与D1组比较,γ波功率明显降低(P<0.05);D3、D4、D5组与D1组比较,θ-γ、α-γ相位幅度耦合(PAC)调制指数明显降低(P<0.05)。在B组内,D2、D3、D4、D5组与D1组比较,γ波功率、θ-γ、α-γPAC调制指数均未见明显降低(P>0.05)。结论在成年癫痫患者左侧边缘系统,丙泊酚可引发γ波功率降低,θ-γ、α-γPAC调制指数明显降低。提示丙泊酚麻醉可能与γ波功率降低、脑电活动PAC降低有关。Objective To observe the effect of different effect-site concentrations of propofol on the stereo-electroencephalography(SEEG)of brain limbic system in adult patients with epilepsy.Methods A total of 14 adult inpatients were selected from the department of Epilepsy surgery,Shanghai Clinical Medical college of Qingdao University from January 2021 to December 2022.These patients'brain limbic systems were implanted with electrode guided by Robotic stereotactic assistance(ROSA),and later the electrode was removed.According to the electrodes implanted in the left or right side of the brain limbic system,the patients were divided into Group A(left side,n=7)and Group B(right side,n=7).Based on the effect-site concentrations of propofol,5 concentration groups were set up:D1 group(0μg/mL),D2 group(2μg/mL),D3 group(3μg/mL),D4 group(4μg/mL)and D5 group(5μg/mL).The effect of different effect-site concentrations of propofol on the EEG of the left and right brain limbic systems was observed.Results In Group A,γwave power was significantly decreased in D2,D3,D4 and D5 groups when compared to D1 group(P<0.05),and modulation indexes ofθ-γandα-γphase amplitude coupling(PAC)were obviously decreased in D3,D4 and D5 groups when compared to D1 group(P<0.05).In Group B,γwave power and modulation indexes ofθ-γandα-γPAC were not obviously decreased in D2,D3,D4 and D5 groups when compared to D1 group(P>0.05).Conclusion In the left limbic system of adult patients with epilepsy,propofol can cause a decrease inγwave power and a significant decrease in the modulation index ofθ-γandα-γPAC.

关 键 词：丙泊酚 大脑边缘系统 立体定向脑电图 相位幅度耦合 

分 类 号：R971+.2[医药卫生—药品] R742.1[医药卫生—药学]