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异丙酚对心内直视手术病人颅内血浆兴奋性氨基酸水平的影响 |
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于灵芝 刘慧贞 张银中 宋振瑞
【摘要】 目的 观察低温体外循环(CPB)心内直视手术相中颅内静脉血中兴奋性氨基酸(EAAs)的变化及复温过程中应用异丙酚的作用。方法 择期心内直视手术病人30例，随机分为对照组及观察组(复温过程中经人工心肺机注入异丙酚)。于麻醉诱导后CPB前(A)、降温33℃时(B)、低温稳定期(C)、复温33℃时(D)、复温开始后1小时(E)和2小时(F)经颈内静脉逆行置管取血样检测血浆EAAs浓度。结果 甘氨酸(Gly)两组B、C、D点值均明显高于A点；谷氨酸(Glu)对照组D点较A点明显升高；天冬氨酸(Asp)对照组D点较A点显著升高，并明显高于观察组。结论 体外循环心内直视手术中颅内静脉血EAAs浓度升高，复温过程中应用异丙酚可减少Glu、Asp水平的升高，但对Gly无影响。
【关键词】 心肺转流术 二异丙酚 兴奋性氨基酸类
Influence of propofol on excitatory amino acids levels of intracranial venous blood during open-heart surgery
YU Lingzhi，LIU Huizhen，ZHANG Yinzhong，et al．
Department of Anesthesiology，Shandong Provincial Hospital，Jinan 250021
【Abstract】 Objective To observe the changes of excitatory amino acids（EAAs）levels in intracranial venous blood during open-heart surgeries under cardiopulmonary bypass（CPB）and the influence of propofol on it when used perirewarmingly．Methods Thirty patients for selective open-heart surgeries were randomly divided into two groups．In group I propofol 1．0 mg.kg－1 was intravenously administered 5-10 min before the start of rewarming and consequently was infused at the rate of 100μg.kg－1.min－1 till the end of rewarming．The group Ⅱ servered as control without any administration．Blood samples were taken via retrograded jugular blub cannula prior to CPB（A），following 33℃ cooling （B），during the deepest temperature（C），at onset of rewarming（D），1h（E）and 2h（F） after the onset of rewarming，to measure the plasma concentrations of EAAs including glutamate（Glu），aspartate（Asp） and glysine（Gly）．Results As compared with the levels before CPB，Glu value increased significantly at D in group Ⅱ （P＜0．05），and remained unchanged in group Ⅰ（P＞0．05），in which there was not significant difference between both groups（P＞0．05）；Asp value rose markedly at D in group Ⅱ（P＜0．05），but decreased obviously at F in group Ⅰ（P＜0．05），in which there were significant differences at D and F between both groups （P＜0．05）；Gly value increa[1] [2] [3] 下一页
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