丙泊酚麻醉对不停跳冠脉搭桥患者围术期心肌肌钙蛋白T水平的影响  

Effect of propofol on cTnT in patients undergoing off-pump coronary artery bypass grafting

作　　者：陶星[1] 李树人[1] 赵志丹[1] 

机构地区：[1]首都医科大学附属北京友谊医院麻醉科,100050

出　　处：《临床麻醉学杂志》2003年第4期197-199,共3页Journal of Clinical Anesthesiology

摘　　要：目的　研究丙泊酚麻醉对不停跳冠脉搭桥患者围术期心肌肌钙蛋白T(cTnT)水平的影响。方法　 2 8例择期接受不停跳冠状动脉搭桥手术的患者依据麻醉维持方法的不同分为对照组 (Ⅰ组 ,1 3例 )和丙泊酚组 (Ⅱ组 ,1 5例 )。Ⅰ组间断静注芬太尼加 1 %异氟醚吸入 ;Ⅱ组持续输注丙泊酚加 1 %异氟醚吸入。分别于入手术室 (T0 )、麻醉诱导平稳后 (T1 )、手术结束即刻 (TST)、术后 4h(T4)、8h(T8)、1 2h(T1 2 )、2 4h(T2 4)和 4 8h(T48)抽静脉血 2ml测定cTnT。结果　两组患者T0 和T1 时cTnT正常 ,术后则显著性升高 ,高峰都出现在术后 8h。两组之间相比 ,虽然丙泊酚组在大多数时间点上 (术后即刻～术后 2 4h)cTnT值比芬太尼组稍低 ,但无显著性差异。结论　本研究未发现临床剂量的丙泊酚能减轻心脏手术对心肌的损伤。Objective To observe the effect of propofol on cTnT in patients undergoing off pump coronary artery bypass grafting.Methods Twenty eight patients were divided into control group (group Ⅰ, n= 13) and propofol group(group Ⅱ, n= 15).The anesthesia was maintained by intermittent injection of fentanyl and 1% isoflurane inhalation in group 1 and continuously propofol infusion and 1% isoflurane inhalation in grpup 2.Serum cTnT concentrations were measured before anesthesia(T 0),after anesthetic induction(T 1),immediately after operation and at 4h,8h,12h,24h,48h after operation.Results The values of cTnT were all in normal range at T 0 as well as T 1, then increased significantly after operation.The peak value was seen at 8h after operation.Although the values of cTnT were lower in group 2 than those in group 1 after operation,there was not statistical difference between the two groups.Conclusion The clinical dosage of propofol does not relieve myocardial injury during coronary surgery. [

关 键 词：丙泊酚 麻醉 不停跳冠脉搭桥 围术期 心肌肌钙蛋白T 影响 

分 类 号：R614[医药卫生—麻醉学]