摘要
目的探讨丙泊酚用于心肺转流(CPB)对全身性血管内皮细胞(VEC)急性损伤的保护作用。方法30例心脏瓣膜置换术病人随机均分为观察组和对照组,CPB过程中分别持续输注丙泊酚、硝酸甘油维持病人血流动力学的稳定。分别于术前、CPB前、CPB30min、停CPB、手术结束、术后1、3d采血动态监测两组病人血浆可溶性血栓调节蛋白(sTM)和血管性假血友病因子(vWF)的变化。结果两组病人血浆sTM和vWF在CPB期间和术后1d均显著增高(P<0·05或P<0·01)。观察组病人CPB期间至术后3d的所有指标均低于对照组(P<0·05或P<0·01)。观察组的指标术后3d恢复到术前水平。对照组未能恢复。结论CPB可导致全身性VEC的急性损伤,丙泊酚可以减轻CPB导致的VEC损伤。
Objective To study the protective effect of propofol on the vascular endothelial cell （VEC） acute injury in the patients undergoing cardiopulmonary bypass （CPB）. Methods Thirty patients scheduled for cardiac valvular replacement under CPB were divided into two groups with 15 cases each. The patients in test group were pumped propofol to maintain homodynamic stability, and those in control group were pumped nitroglycerine instead of propofol. Blood samples were withdrawn before skin incision,before CPB,at 30 rain after CPB,the end of CPB,the end of operation,on the first and the third postoperative day for detecting the levels of soluble thrombomodulin （sTM） and yon Willebrand factor（vWF）. Results The levels of sTM and vWF significantly elevated during CPB and on the first postoperative day in the two groups as compared with those before operation （P〈0.05 or P〈0.01）. The levels of sTM and vWF in test group returned to the level before operation, but the levels in control group did not, which were significantly higher in control group than those in test group in the three postoperative days （P〈0.05 or P〈0.01）. Conclusion CPB can induce extensive acute VEC damage,which can be attenuated by propofol infusion.
出处
《临床麻醉学杂志》
CAS
CSCD
2008年第4期281-283,共3页
Journal of Clinical Anesthesiology
