CAJ | 학술논문

目的：观察氟比洛芬酯对止血带诱发下肢缺血再灌注损伤的影响。方法择期腰硬联合麻醉下行下肢远端手术患者90例， ASA分级Ⅰ~Ⅱ级，年龄30～59岁，采用随机数字表法将患者分为三组(n=30)：对照组(C组)、氟比洛芬酯小剂量组（D1组）、氟比洛芬酯剂量组（D2组）。患肢驱血后，应用止血带，压力220mmHg，持续时间不超过90 min。止血带充气前10min，D1组静脉缓慢注射氟比洛芬酯1mg/kg；D2组静脉缓慢注射氟比洛芬酯2mg/kg；C组静脉缓慢注射生理盐水5mL。分别于术前（T0）、止血带放气后30min（T1）、止血带放气后120min（T2）时采集静脉血5 mL,测定血清丙二醛（MDA）、超氧化物歧化酶（SOD）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）浓度。结果三组在T1、T2时的MDA、SOD、IL-6、IL-8、TNF-α浓度低于T0时（P ＜0.05）；在T1、T2时D1和D2组的MDA、SOD、IL-6、IL-8、TNF-α浓度低于C组(P ＜0.05)；血浆MDA浓度在T1和T2时D2组明显低于D1组（P＜0.05）。结论氟比洛芬酯能够减轻止血带诱发下肢缺血再灌注损伤的炎性反应。
목적：관찰불비락분지대지혈대유발하지결혈재관주손상적영향。방법택기요경연합마취하행하지원단수술환자90례， ASA분급Ⅰ~Ⅱ급，년령30～59세，채용수궤수자표법장환자분위삼조(n=30)：대조조(C조)、불비락분지소제량조（D1조）、불비락분지제량조（D2조）。환지구혈후，응용지혈대，압력220mmHg，지속시간불초과90 min。지혈대충기전10min，D1조정맥완만주사불비락분지1mg/kg；D2조정맥완만주사불비락분지2mg/kg；C조정맥완만주사생리염수5mL。분별우술전（T0）、지혈대방기후30min（T1）、지혈대방기후120min（T2）시채집정맥혈5 mL,측정혈청병이철（MDA）、초양화물기화매（SOD）、종류배사인자-α（TNF-α）、백세포개소-6（IL-6）、백세포개소-8（IL-8）농도。결과삼조재T1、T2시적MDA、SOD、IL-6、IL-8、TNF-α농도저우T0시（P ＜0.05）；재T1、T2시D1화D2조적MDA、SOD、IL-6、IL-8、TNF-α농도저우C조(P ＜0.05)；혈장MDA농도재T1화T2시D2조명현저우D1조（P＜0.05）。결론불비락분지능구감경지혈대유발하지결혈재관주손상적염성반응。
Objective To observe the effects of flurbiprofen on tourniquet-induced lower extremity ischemia-reperfu-sion (I/R) injury. Methods Ninety ASA I or II patients, aged 30-59 years, scheduled for elective orthopedic operation on CSEA,were randomly assigned into 3 groups (n=30 each):control group (group C),low dose flurbiprofen (group D1) and flurbiprofen (group D2). A tourniquet was applied after affected limb blood droved and inflated (80kPa) and dura-tion of less than 90 min. Patients in group D1 were infused flurbiprofen 1mg/kg slowly on 10 min before the tourniquet inflated and patients in group D2 infused flurbiprofen 2mg/kg. Patients in group C received normal saline 5mL.Blood samples were taken before operation (T0) and taken 30min(T1),2h(T2) after tourniquet release to determine the plasma concentrations of MDA, SOD, TNF-α,IL-6,IL-8.Results The plasma concentrations of MDA, SOD, TNF-α,IL-6,IL-8 in these three group was lower at T1 and T2 than it at T0(P<0.05). The plasma concentrations of MDA, SOD, TNF-α, IL-6,IL-8 in group D1and D2 was lower at T1 and T2 than it at T0(P <0.05). The plasma concentrations of MDA was lower at T2 than it at T1(P<0.05). Conclusion Flurbiprofen can reduce inflammation on tourniquet-induced lower ex-tremity ischemia-reperfusion injury.