摘要
目的 探讨美蓝对静滴普鲁卡因 (PROC)致人体红细胞过氧化损伤的影响。方法 40例择期行上腹部手术患者根据麻醉方法不同随机分为静脉普鲁卡因复合麻醉 (IPA)组 (观察组 ,n =2 0 )和芬太尼组 (对照组 ,n =2 0 )。分别观察麻醉诱导前、IPA 1 2 0min、IPA 1 80min、静脉注射美蓝 (1～ 2mg/kg)后 30min患者血内一氧化氮 (NO)、氧自由基 (OFR)、超氧化物歧化酶 (SOD)、过氧化氢酶 (CAT)、高铁血红蛋白 (MHb)含量变化 ,IPA 60、1 2 0、1 80min血浆对氨基苯甲酸 (PABA)浓度与MHb增量的关系。结果 IPA组 1 2 0、1 80min与麻醉诱导前相比NO、OFR、MHb有显著性升高 (P <0 0 5 ,P <0 0 5 ,P <0 0 1 ) ;SOD、CAT较麻醉前显著性降低 (P <0 0 5 ,P <0 0 1 )。而对照组诸指标无显著变化。IPA期间血浆PABA分别与MHb增量间自始至终呈显著正相关关系 (r =0 .892 ,0 .71 4 6 ,0 .851 7,均P <0 0 0 1 )。IPA组经美蓝治疗后诸指标均恢复至正常水平。结论 PROC在体内的代谢产物具有强氧化剂特性 ,可致机体NO、OFR水平升高 ,红细胞SOD、CAT活性受抑制及与PROC剂量相关的高铁血红蛋白血症。美蓝具有OFR清除剂特性 。
Objective To study the protective effect of Methylene Blue (MB)on the per-oxidative injured erythrocyte induced by intravenous Procaine in vivo Methods Forty patients undergoing elective adbmental surgery were divided randomly into receive intravenous Procaine anesthesia(IPA)group and Fentanyl group as control. Blood sample was taken before anesthesia,120,180 minutes after IPA and 30 minutes after treatment with MB(1～2 mg/kg)to determined the changes of the levels of nitric oxide (NO),oxygen free radical (OFR),superoxide dismutase(SOD),catalase (CAT) and methemoglobine(MHb).The relationship of P-aminobenzoic acid (PABA,a metablite of procaine) and MHb during IPA.Results Compared with before IPA,the levels of NO,OFR,MHb in group IPA were significantly increased at 120, 180 minutes after IPA. At same time CAT were significantly decreased.No changes of every indexes at control group during anesthesia.The plasma level of PABA was positively related with the increase content of MHb, 30 minutes after MB iv administration, NO,OFR,MHb,SOD,CAT were all reduced to the normal levels.Conclusion It is indicated that the metabolites products of PROC in vivo possess effects of power oxidant were the main factors causing methemoglobinemia. MB may act as an OFR scavenger and markedly protect erythrocyte from chemical drug induced lipid per-oxidation injury.
出处
《中国急救医学》
CAS
CSCD
北大核心
2002年第1期13-15,共3页
Chinese Journal of Critical Care Medicine
基金
海南省自然科学基金资助项目(No .2 0 0 0 - 80 0 10 )
