摘要
目的比较丙泊酚和异氟醚对胰岛素抵抗及促炎细胞因子的影响。方法择期上腹部手术患者30例,随机均分为丙泊酚组(P组)和异氟醚组(I组)。于麻醉前、麻醉后2h及术后24h采静脉血测血糖(Glu)、胰岛素(IN)、肿瘤坏死因子α(TNF-α)和白细胞介素-6(IL-6),并计算胰岛素敏感指数(ISI)及胰岛素抵抗指数(IRI)。结果与麻醉前比较,麻醉后2 h P组Glu稍升高,但差异无统计学意义;Ⅰ组Glu明显升高(P<0.01);术后24h两组患者的Glu均明显升高(P<0.05或P<0.01);麻醉后2 h、术后24 h两组患者IN、IRI、TNF-α、IL-6明显升高(P<0.05或P<0.01),ISI明显下降(P<0.05或P<0.01)。麻醉后2hⅠ组ISI明显低于P组(P<0.05),IRI、TNFα-、IL-6明显高于P组(P<0.05)。结论丙泊酚及异氟醚均不能完全抑制应激反应及胰岛素抵抗,但与异氟醚相比,丙泊酚在一定程度上可以减轻应激反应和胰岛素抵抗。
Objective To compare the influence of propofol and isoflurane on insulin resistance and proinflammatory cytokines. Methods Thirty patients scheduled for epigastric operation were divided into two groups randomly with 15 cases each. The patients in group P were anesthetized with propofol, and in group Ⅰ with isoflurance. Blood glucose, insulin, TNF-α and IL-6 in venous blood were measured at 2 h after anesthesia induction and 24 h after operation. Insulin sesitivity index（ISI） and insulin resistance index （IRI） were calculated. Results Compared with before anesthesia, all parameters,except glucose, were significantly decressed at 2h after anesthesia induction and 24h after operation（P〈0. 05 or P〈0. 01）. Conclusion The stress reaction can not be completely suppressed by propofol or isoflurance. Propofol is stronger in suspressing stress reaction than isoflurance inhalation.
出处
《临床麻醉学杂志》
CAS
CSCD
2008年第1期8-10,共3页
Journal of Clinical Anesthesiology
基金
首都医科大学基础与临床研究基金(编号:03JL08)
关键词
丙泊酚
异氟醚
胰岛素抵抗
促炎细胞因子
Propofol
Isoflurane
Insulin resistance
Proinflammatory cytokine
