异丙酚对体外循环肺缺血再灌注损伤影响.doc

异丙酚对体外循环肺缺血再灌注损伤影响【摘要】目的：探讨异丙酚对心肺转流术（CPB）肺缺血再灌注损伤的影响及可能机制。方法：选取20例年龄4~12岁小儿先天性心脏病，随机分为异丙酚组（P组）和对照组（C组），每组10例，P组诱导后按异丙酚3~5 mg/（kg#8226;h）微量泵持续泵入至术毕，C组用等量生理盐水代替。分别于麻醉诱导后5分钟(T0)，阻断主动脉10分钟（T1），开放主动脉30分钟(T2)，体外循环结束4小时(T3)，体外循环结束24小时(T4)采集桡动脉血测细胞间黏附分子－1（ICAM-1），超氧化物歧化酶（SOD），丙二醛（MDA），根据动脉血气计算肺呼吸指数（RI）。结果：与T0比较，T1~4两组ICAM-1，SOD，MDA，RI值明显升高（P0.05）。结论：异丙酚能降低CPB期间ICAM-1表达及减少氧自由基的生成，抑制机体的炎症反应和氧化损伤，对CPB肺缺血再灌注损伤有保护作用。 【关键词】异丙酚；细胞间黏附分子－1；心肺转流术；缺血再灌注损伤 文章编号：1009-5519（2007）15-2229-02 中图分类号：R64 文献标识码：A Effect of propofol on the lung ischemia reperfusion injury during cardiopulmonary bypass ZHU Hai-yan，LI Li，ZHANG Liang-bin （Department of Anesthesiology，The Third Affiliated Hospital， Zhongnan University，Changsha 410011，China） 【Abstract】Objective：Ischemia reperfusion injury of the lung after cardiopulmonary bypass resulted from inflammatory reaction and oxidant-mediated celluar damage. The aim of this study was to evaluate the potential of the anesthetic propofol in inhibiton of the inflammatory reaction andantioxidant properties by measuring the plasma intercellular adhension molecule-1，SOD，MDA levels andrespiratory index during and after cardiopulmonary bypass. Methods：Twentypuerilepatientswithcongenital heart disease were randomly divided into propofol and control groups of ten patients for each .Patients received IV bolus of either propofol 3~5 mg/（kg#8226;h）(propofol group) or an equal amount of isotonic sodium chloride solution (control group) respectively after introduction of anesthesia until the end of operation. Blood samples were taken from radial artery 5min after introduction of anesthesia(T0)， 10min after aortic blocking (T1)，30min after aortic declamping(T2)，4hour(T3)，24hour(T4) after CPB for determination of plasma ICAM-1，SOD，MDA concentrations and respiration index.Results:There was no significant difference between two group in age，gender，weight，CPB time，operation time and aortic cross-damping time.Compared with those at T0，the concentrations of ICAM