摘要
目的探究丙泊酚与七氟烷对单肺通气麻醉患者肺组织血红素氧合酶-1(HO-1)、血清过氧化氢酶(CAT)水平的影响及肺保护作用。方法前瞻性选取2019年2月至2020年12月在南京市第一医院行单肺通气麻醉术的患者67例作为研究对象。采用随机数字表法分为观察组(n=34)与对照组(n=33),对照组采用七氟烷诱导麻醉,观察组采用丙泊酚诱导麻醉。对比2组麻醉诱导前(T_(0))、气管插管后5 min(T_(1))、单肺通气后30 min(T_(2))、恢复双肺通气时(T_(3))、恢复双肺通气后15 min(T_(4))、手术结束时(T_(5))的肺功能指标[肺泡-动脉氧分压差(PA-aO_(2))、氧合指数(OI)、呼吸指数(RI)]和血清CAT水平、肺组织HO-1表达水平、肺氧合指数(PaO_(2)/FiO_(2))、临床相关指标情况。结果2组T_(1)、T_(2)、T_(3)、T_(4)时刻PA-aO_(2)水平均较T_(0)时刻增加,差异均有统计学意义(P<0.05);2组T_(1)、T_(2)、T_(3)时刻OI水平均较T_(0)时刻下降,T_(2)、T_(3)时刻观察组OI水平高于对照组,差异均有统计学意义(P<0.05);观察组在T_(1)、T_(2)、T_(3)、T_(4)、T_(5)时刻RI水平均低于对照组,差异均有统计学意义(P<0.05)。2组T_(1)、T_(2)、T_(3)、T_(4)、T_(5)时刻血清CAT水平均较T_(0)时刻下降,观察组高于对照组,差异均有统计学意义(P<0.05)。观察组肺组织HO-1水平与PaO_(2)/FiO_(2)均高于对照组,差异均有统计学意义(P<0.05)。观察组睫毛反射消失时间为(80.45±24.34)min,明显长于对照组[(52.78±18.73)min],差异有统计学意义(P<0.05);2组呼叫睁眼时间、自主呼吸恢复时间、拔管时间相比差异无统计学意义(P>0.05)。结论丙泊酚诱导单肺通气麻醉可上调肺组织HO-1表达、减轻机体氧化应激反应,从而起到肺保护作用。七氟烷诱导速度较快,且不影响术后恢复速度。
Objective To investigate the effects of propofol and sevoflurane on the levels of heme oxygenase-1(HO-1)and serum catalase(CAT)in the lung tissue of patients with single lung ventilation anesthesia and their lung protection.Methods A total of 67 patients with single lung ventilation anesthesia in Nanjing First Hospital from February 2019 to December 2020 were prospectively selected as the study subjects and randomly divided into the observation group(n=34)and the control group(n=33)by random number table method.The control group was anesthetized by sevoflurane,and the observation group was anesthetized with propofol.The lung function indexes,the level of serum CAT before induction of anesthesia(T_(0)),5 minutes after tracheal intubation(T_(1)),30 minutes after single-lung ventilation(T_(2)),when two-lung ventilation was restored(T_(3)),15 minutes after two-lung ventilation(T_(4)),at the end of the operation(T_(5)),the expression level of HO-1 in lung tissues,and pulmonary oxygenation index(PaO_(2)/FiO_(2)),clinical related indicators were compared between the two groups.Results The levels of PA-aO_(2) at T_(1),T_(2),T_(3),and T_(4) in the two groups increased compared with T_(0),and the differences were statistically significant(P<0.05);the levels of OI at T_(1),T_(2),and T_(3) in the two groups decreased compared with T_(0),the level of OI at T_(2) T_(3) in the observation group were higher than thsoe in the control group,and the differences were statistically significant(P<0.05).The levels of RI in the observation group at T_(1),T_(2),T_(3),T_(4),and T_(5) were lower than those in the control group,and the differences were statistically significant(P<0.05);The levels of serum CAT at T_(1),T_(2),T_(3),T_(4),and T_(5) in the two groups were lower than those at T_(0),and the levels of serum CAT in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).The level of HO-1 and PaO_(2)/FiO_(2) in the lung tissue of the observation group were higher stati
作者
徐少东
李菁
陈宝林
XU Shao-dong;LI Jing;CHEN Bao-lin(Department of Pharmacy,Nanjing First Hospital,Nanjing Jiangsu 210006,China;Department of Anesthesiology,Nanjing First Hospital,Nanjing Jiangsu 210006,China)
出处
《临床和实验医学杂志》
2021年第21期2345-2349,共5页
Journal of Clinical and Experimental Medicine
基金
江苏省科技厅科研基金(编号:B201700213)。
