摘要
目的观察地氟烷对老年冠脉搭桥手术患者血清神经元特异性烯醇化酶(NSE)和S-100β的影响,探讨地氟烷对老年冠脉搭桥手术患者的脑保护作用。方法 30例行择期冠脉搭桥手术患者,年龄大于65岁,心功能Ⅱ～Ⅲ级,随机分为对照组和地氟烷组,每组15例。均采用静吸复合麻醉,2组麻醉诱导方式相同,体外循环期间对照组予地西泮、氯胺酮维持麻醉,地氟烷组吸入1.0最低肺泡有效浓度(MAC)的地氟烷维持麻醉。分别于术前(T1)、术终(T2)、术后12 h(T3)及术后24 h(T4)测定血清NSE和S-100β蛋白水平,并于T1和T4时记录简易智能量表(MMSE)评分。结果与T1相比,对照组T2、T3时NSE水平升高(P<0.05),S-100β蛋白水平仅在T2时显著升高(P<0.01)。地氟烷组仅在T2时S-100β蛋白水平升高(P<0.05),T2时NSE和S-100β蛋白水平均低于对照组(P<0.05)。对照组T4时MMSE评分下降了(1.1±s 0.4)分,地氟烷组下降了(0.6±0.3)分,2组差异显著(P<0.05)。结论地氟烷对老年冠脉搭桥手术患者有一定的脑保护作用,降低血清NSE和S-100β水平可能为其机制之一。
AIM To observe the effects of desflurane on serum neron-specific enolase（NSE）and S-100 β protein levels in the old patients undergoing coronary artery bypass grafting（CABG）and investigate the brain protection of desflurane.METHODS Thirty patients（over 65 years old,cardiac function Ⅱ-Ⅲ）scheduled for CABG were randomly divided into two groups,15 in each.The anesthesia inductions were identical in the two groups and intravenous-inhalation combined anesthesia were adopt in both groups.During cardiopulmonary bypass,diazepam and ketamine in the control group and 1.0 MAC desflurane in the desflurane group were applied to maintenance of anesthesia.Serum NSE and S-100 β protein levels was assayed at four time points：preoperative（T1）,the end of cardiosurgery（T2）,12 h after cardiosurgery（T3）,and 24 h after cardiosurgery（T4）.The mean mini-mental state examination（MMSE）scores were measured at T1 and T4.RESULTS Compared with T1,serum NSE level increased at T2 and T3（P 0.05）,and serum S-100 β level only increased at T2 in the control group（P 0.01）.The serum S-100 β level raised in the desflurane group at T2（P 0.05）,but the serum NSE and S-100 β levels in the desflurance group were less than those in the control group at T2（P 0.05）.The MMSE scores decreased（1.1 ± s 0.4）in the control group and（0.6 ± 0.3）in the desflurance group,with significant difference between the two groups（P 0.05）.CONCLUSION Desflurane have some brain protection role in the old patients undergoing CABG by reducing the serum NSE and S-100 β levels.
出处
《中国新药与临床杂志》
CAS
CSCD
北大核心
2010年第11期847-850,共4页
Chinese Journal of New Drugs and Clinical Remedies
基金
佛山市重点科技攻关项目(200708039)
