CAJ | 학술논문

目的：观察不同剂量丙泊酚注射液和丙泊酚中/长链脂肪乳注射液短时间输注血浆酮体比率的变化,以此评价其对肝脏能量代谢的影响。方法选择择期手术患者40例,年龄18~50岁,ASA Ⅰ或Ⅱ级,随机分为四组,每组10例,分别为：丙泊酚注射液4 mg·kg-1·h-1维持麻醉(L4组)、丙泊酚注射液6 mg·kg-1·h-1维持麻醉(L6组)、丙泊酚中/长链脂肪乳注射液4 mg·kg-1·h-1维持麻醉(M4组)、丙泊酚中/长链脂肪乳注射液6 mg·kg-1·h-1维持麻醉(M6组)。记录诱导前(T0)、气管插管后(T1)、维持输注丙泊酚麻醉2 h 后(T2)、术毕时(T3)的 MAP、HR、SpO2、PET CO2,并在T1、T2时点,取静脉血检测乙酰乙酸、β-羟丁酸含量,计算血酮体比率(乙酰乙酸/β-羟丁酸)。结果四组患者 T0~T3时 MAP、HR、SpO2、PET CO2和 T1、T2时乙酰乙酸、β-羟丁酸含量和血酮体比率之间差异均无统计学意义。结论不同剂量丙泊酚和不同剂量丙泊酚中/长链脂肪乳注射液短时间持续输注对肝脏能量代谢无明显影响；相同剂量丙泊酚注射液和丙泊酚中/长链脂肪乳注射液短时间持续输注对肝脏能量代谢无明显影响。
목적：관찰불동제량병박분주사액화병박분중/장련지방유주사액단시간수주혈장동체비솔적변화,이차평개기대간장능량대사적영향。방법선택택기수술환자40례,년령18~50세,ASA Ⅰ혹Ⅱ급,수궤분위사조,매조10례,분별위：병박분주사액4 mg·kg-1·h-1유지마취(L4조)、병박분주사액6 mg·kg-1·h-1유지마취(L6조)、병박분중/장련지방유주사액4 mg·kg-1·h-1유지마취(M4조)、병박분중/장련지방유주사액6 mg·kg-1·h-1유지마취(M6조)。기록유도전(T0)、기관삽관후(T1)、유지수주병박분마취2 h 후(T2)、술필시(T3)적 MAP、HR、SpO2、PET CO2,병재T1、T2시점,취정맥혈검측을선을산、β-간정산함량,계산혈동체비솔(을선을산/β-간정산)。결과사조환자 T0~T3시 MAP、HR、SpO2、PET CO2화 T1、T2시을선을산、β-간정산함량화혈동체비솔지간차이균무통계학의의。결론불동제량병박분화불동제량병박분중/장련지방유주사액단시간지속수주대간장능량대사무명현영향；상동제량병박분주사액화병박분중/장련지방유주사액단시간지속수주대간장능량대사무명현영향。
Objective To observe the effect of different doses of propofol injection and propofol medium/long-chain fat emulsion injection in short time infusion on plasma ketone body ratio,to eva-lute its effecton hepatic energy metabolism.Methods Forty patients,aged 18-50 years old,ASA Ⅰ orⅡ undergoing selective surgery were randomly divided into 4 groups with 10 cases in each;propofol injection 4 mg·kg-1·h-1 maintain anesthesia (group L4 ),propofol injection 6 mg·kg-1·h-1 maintain anesthesia (group L6 ),propofol medium/long-chain fat emulsion injection 4 mg·kg-1·h-1 maintain anesthesia (group M4 ),propofol medium/long-chain fat emulsion injection 6 mg·kg-1·h-1 maintain anesthesia (group M6 ).MAP,HR,SpO2 and PET CO2 were recorded before anesthesia induction (T0 ),after tracheal intubation (T1 ),after 2 hours infusion of propofol (T2 )and operation completed (T3 ).The blood samples were collected at T1 and T2 to detect the level of acetoacetate,β-hydroxybu-tyrate and to calculate the blood ketone body ratio (the ratio of acetoacetate andβ-hydroxybutyrate). Results MAP,HR,SpO2 ,PET CO2 at T0-T3 and acetoacetate,β-hydroxybutyrate,blood ketone body ratio at T1 ,T2 showed no significant statistic difference.Conclusion Different doses of propofol and different doses of propofol medium/long-chain fat emulsion injection in short time continuous in-fusion has no obvious effect on hepatic energy metabolism;same dose of propofol injection and propo-fol medium/long-chain fat emulsion injection in short time continuous infusion has no obvious effect on hepatic energy metabolism.