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《烏司他丁對(duì)體外循環(huán)心內(nèi)直視術(shù)患者具腦保護(hù)的作用》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在教育資源-天天文庫(kù)。
1、烏司他丁對(duì)體外循環(huán)心內(nèi)直視術(shù)患者具腦保護(hù)的作用第27卷第l2期2007年l2月南京醫(yī)科大學(xué)(自然科學(xué)版)ACTAUNIVERSITATISMEDICINALISNANJING(NaturalScience)烏司他丁對(duì)體外循環(huán)心內(nèi)直視術(shù)患者具腦保護(hù)的作用邵東華,杭黎華,傅誠(chéng)章,王洪,楊映紅(江蘇大學(xué)附屬醫(yī)院麻醉科,江蘇鎮(zhèn)江212001;南京醫(yī)科大學(xué)第一附屬醫(yī)院麻醉科.江蘇南京210029)[摘要]目的:探討圍麻醉期烏司他丁對(duì)體外循環(huán)(CPB)下行心臟手術(shù)患者全身及腦部炎性反應(yīng)的影響及其腦保護(hù)作用.方法:擇期心臟瓣膜置換患者24例,隨機(jī)分為烏司他丁組(u組)和
2、對(duì)照組(c組).u組患者在麻醉后和轉(zhuǎn)機(jī)時(shí)分別靜脈泵注烏司他丁,泵注時(shí)間均為1h.C組患者則給予等量容積的生理鹽水代替.分別于麻醉后手術(shù)前(T1),體外循環(huán)開始后30min(T2),體外循環(huán)結(jié)束后1h(T3),4h(T4)和20h(T5)同時(shí)抽取動(dòng)脈血和頸靜脈球血.采用ELISA法測(cè)定動(dòng)靜脈血漿中TNF—o/.,IL-6及頸靜脈球血S100B蛋白的濃度,并計(jì)算同一時(shí)點(diǎn)頸靜脈球血和動(dòng)脈血之差A(yù)TNF—d,AIL-6值.結(jié)果:與各自Tl相比,兩組患者血漿TNF—d,IL一6,ATNF—d,AIL-6的濃度在T2,rI'3,T4,T5明顯升高(P<0.0l或
3、P<0.05)且C組升高的幅度明顯大于u組(P<0.0l或P<0.05).與Tl相比,兩組患者血漿S100B蛋白水平在體外循環(huán)開始后明顯升高(P<0.01),rI'3達(dá)到高峰,T4開始下降,T5明顯下降.u組T2,rI'3,T4,T5的S100B蛋白濃度升高的水平明顯低于c組(P<0.01).結(jié)論:烏司他丁可減輕CPB心臟手術(shù)患者全身和腦局部炎性反應(yīng),可降低頸靜脈球血漿中S100B蛋白水平升高的幅度.具有一定的腦保護(hù)作用.[關(guān)鍵詞]烏司他丁;體外循環(huán);腦保護(hù)[中圖分類號(hào)]R614.2[文獻(xiàn)標(biāo)識(shí)碼]A[文章編粵]1007-436
4、8(2007)12—1407—04ClinicalstudyofulinastatinonbrainprotectionduringcardiopulmonarybypassSHAODong-hua,HANGLi-hua,FUCheng—zhang,WANGHong,YANGYing-hong(DepartmentofAnesthesiology,theAffliatedHospitalofJiangsuUniversity,iang212001;DepartmentofAnesthesiology,theFirstAffiliatedHospitalof
5、NJMU,Nanjing210029,China)[Abstract]Objective:Toinvestigatethe9ffectsofulinastatin(urI1)onsystemicandcerebralinflammatoryresponseandonbrainprotectionduringcardiopulmonarybypass(CPB).Methods:Twenty—fourpatients,undergoingelectivecardiacvalvereplacementwererandomlydividedinto2groups:
6、ulinastatingroup(GroupU,n=12)andcontrolgroup(GroupC,n=12).IngroupU,UrI1(1xl04U/kg)wasinfusedintravenouslyaftertheinductionofanesthesiaandduringCPB,respectively.Eachinfusiontimewasabout1h.InGroupCnormalsalinewasveninsteadofUrI1.Bloodsamplesweretakensimultaneouslyfromarteryandjugula
7、rbulbafterinductionofanesthesia(T1),0.5hafterCPBbeginning(T2),1h(T3),4h(T4)and20h(T5)afterCPBterminationfordeterminationofTNFot,IL-6andS100B.S100Bsamplesweretakenonlyfromjugularbulb.Thejugularbulb-arterialgradientsofthesecytokines(ATNFctandAIL-6)werecalculated.Results:Theconcentra
8、tionofTNF-ot,IL-6,ATNF—etandAIL-6
