摘要
目的比较丙泊酚、七氟醚及丙泊酚复合七氟醚全麻对二尖瓣置换术患者缺血-再灌注心肌功能的影响。方法择期行心肺转流(CPB)二尖瓣置换术患者45例,随机均分为三组,分别采用丙泊酚(P组)、七氟醚(S组)或丙泊酚复合七氟醚(PS组)全麻。于麻醉诱导前(T0)、升主动脉开放后2h(T1)、4h(T2)、8h(T3)、24h(T4)、48h(T5)采集动脉血测定心肌肌钙蛋白I(cTnI)和丙二醛(MDA)浓度、肌酸激酶同工酶(CK-MB)和超氧化歧化酶(SOD)活性。结果与T0时比较,T1～T5时三组血浆cTnI浓度、CK-MB活性明显升高(P<0.05);T1～T4时三组血浆MDA浓度升高,而SOD活性明显降低(P<0.05)。与S组比较,T1～T5时P组、PS组血浆cTnI浓度、T2～T5时CK-MB活性明显升高(P<0.05);T1～T4时血浆MDA浓度明显升高,而SOD活性明显降低(P<0.05)。结论在CPB下行二尖瓣置换术七氟醚维持麻醉有更好的心肌保护作用。
Objective To compare the effect of different anesthesia method with propofol, sevoflurane or propofol combined with sevoflurane on myocardial injury in the mitral valve replacement surgery patients. Methods Forty-five patients were randomly assigned to propofol group （group P）, sevoflurane group （group S）, or propofol combined with sevoflurane group （group PS） with 15 cases each. Arterial blood levels of cTnI, CK-MB, MDA and SOD were determined at pre- induction （To）, 2 h （T1）, 4 h （T2）, 8 h （T3）, 24 h （T4） and 48 h （Ts） after unclamping of aorta. Results The plasma levels of cTnI and CK-MB were significantly increased at T1-T2 compared with To. The plasma SOD concentration was significantly decreased and MDA increased at T1-T4 （P 〈 0. 05）. Compared with group S, the plasma cTnI concentration at T1-T5 and CK-MB at T2-T5 decreased, MDA at T1-T4 increased and SOD decreased in group P and PS（P〈0. 05）. Conclusion Sevoflurane anesthesia is beneficial for myocardial protection in mitral valve replacement surgery patients.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2013年第4期347-349,共3页
Journal of Clinical Anesthesiology
关键词
丙泊酚
七氟醚
心肌保护
缺血-再灌注损伤
Propofol
Sevoflurane
Myocardial protection
Ischemia-reperfusion injury
