摘要
目的探讨异氟醚预处理对心肌缺血-再灌注损伤的保护效应及机制。方法择期行心脏瓣膜置换术的风湿性心脏瓣膜病病人32例，随机分为异氟醚组和对照组，每组16例。异氟醚组以1．5％～2％异氟醚吸人复合芬太尼维持麻醉，心肺转流（CPB）开始前洗脱10min，CPB后以芬太尼维持麻醉；对照组以芬太尼维持麻醉。分别于麻醉前（T0）、CPB前（T1）、CPB30min（T2）、术后8h（T3）、24h（T4）抽取中心静脉血测定一氧化氮（NO）、NO合酶（NOS）与心肌肌钙蛋白Ⅰ（cTnⅠ）浓度。结果两组病人T0时NO、NOS与cTnⅠ浓度差异无显著意义；异氟醚组T1、T2时NO、NOS浓度明显高于对照组（P〈0．05），T3、T4时cTnⅠ浓度明显低于对照组（P〈0．05）。结论异氟醚具有心肌预适应作用，其机制可能与增加NO释放有关。
Objective To investigate the protective effect and its mechanism of isoflurane preconditioning on ischemia-reperfusion myocardium. Methods - Thirty two patients scheduled for valve replacement were randomly divided into two groups with 16 cases each. Anesthesia was maintained by inhalation of isoflurane between 1.5% and 2% combined with intermittent injection of fentany in isoflurane group. Isoflurane was washed out for 10 min before CPB, and anesthesia was maintained with intermittent injection of fentanyl after beginning of CPB. Blood samples were taken from CVP line for determinations of serum nitric oxide （NO） and NO synthase（NOS） and cardiac troponin Ⅰ （cTnⅠ） before anesthesia induction （T0）, before CPB （T1）, at 30 rain of CPB（T2 ）, 8 h（T3 ） and 24 h （T4） after operation. Results Serum concentrations of NO, NOS and cTnⅠ at T0 were not statistically different between two groups. NO and NOS at T1 and T2 in isoflurane group were significantly higher than those in control group（P〈0.05）.Serum cTnI concentration at Ta and T4 in isoflurane group was significantly lower than that in control group. Conclusion Isoflurane preconditioning can protect the myocardium from ischemia-reperfusion injury and its mechanism is probably related to NO release.
出处
《临床麻醉学杂志》
CAS
CSCD
2006年第7期493-495,共3页
Journal of Clinical Anesthesiology
关键词
异氟醚
预适应
心肺转流
心肌再灌注损伤
一氧化氮
肌钙蛋白Ⅰ
Isoflurane
Preconditioning
Cardiopulmonary bypass
Myocrdial reperfusion injury
Nitric oxide
Cardiac troponin Ⅰ
