医药导报
醫藥導報
의약도보
HERALD OF MEDICINE
2014年
9期
1157-1159
,共3页
徐鲁峰%潘雯%宫建%郭凤%封瑞%崔文瑶%吕福斌%高成杰
徐魯峰%潘雯%宮建%郭鳳%封瑞%崔文瑤%呂福斌%高成傑
서로봉%반문%궁건%곽봉%봉서%최문요%려복빈%고성걸
丙泊酚%异氟烷%肿瘤,神经组织%肿瘤坏死因子%白细胞介素%细胞黏附分子
丙泊酚%異氟烷%腫瘤,神經組織%腫瘤壞死因子%白細胞介素%細胞黏附分子
병박분%이불완%종류,신경조직%종류배사인자%백세포개소%세포점부분자
Propofol%Isoflurane%Neoplasms,nervous tissue%Tumor necrosis factor%Interleukin%Intercellular adhesion molecular
目的：观察丙泊酚和异氟烷对颅内肿瘤患者炎性细胞因子[肿瘤坏死因子α( TNF-α)、白细胞介素1( IL-1)和细胞黏附分子-1(ICAM-1)]的影响,探讨丙泊酚脑保护作用机制。方法颅内肿瘤手术患者168例,随机分为丙泊酚组和异氟烷组,各84例。丙泊酚组血浆靶控输注丙泊酚3~6μg · mL-1,异氟烷组给予1%~2%异氟烷持续吸入。患者均于麻醉诱导前、手术后0 h、手术后24 h和手术后48 h抽取静脉血,测定血清TNF-α、IL-1和ICAM-1的含量。结果两组患者手术后血清TNF-α、IL-1和ICAM-1含量均呈上升趋势。手术后24 h,丙泊酚组和异氟烷组TNF-α分别为(69.11±8.95),(76.26±11.28)μg·mL-1；IL-1分别为(21.57±3.19),(29.58±4.38) ng·L-1；ICAM-1分别为(1.63±0.24),(1.94±0.29) g·L-1；手术后48 h,丙泊酚组炎性细胞因子含量也均较异氟烷组降低(P<0.05或P<0.01)。结论丙泊酚靶控输注比异氟烷吸入可更好地降低颅内肿瘤患者手术后炎性反应水平,这可能是丙泊酚发挥脑保护作用的机制之一。
目的：觀察丙泊酚和異氟烷對顱內腫瘤患者炎性細胞因子[腫瘤壞死因子α( TNF-α)、白細胞介素1( IL-1)和細胞黏附分子-1(ICAM-1)]的影響,探討丙泊酚腦保護作用機製。方法顱內腫瘤手術患者168例,隨機分為丙泊酚組和異氟烷組,各84例。丙泊酚組血漿靶控輸註丙泊酚3~6μg · mL-1,異氟烷組給予1%~2%異氟烷持續吸入。患者均于痳醉誘導前、手術後0 h、手術後24 h和手術後48 h抽取靜脈血,測定血清TNF-α、IL-1和ICAM-1的含量。結果兩組患者手術後血清TNF-α、IL-1和ICAM-1含量均呈上升趨勢。手術後24 h,丙泊酚組和異氟烷組TNF-α分彆為(69.11±8.95),(76.26±11.28)μg·mL-1；IL-1分彆為(21.57±3.19),(29.58±4.38) ng·L-1；ICAM-1分彆為(1.63±0.24),(1.94±0.29) g·L-1；手術後48 h,丙泊酚組炎性細胞因子含量也均較異氟烷組降低(P<0.05或P<0.01)。結論丙泊酚靶控輸註比異氟烷吸入可更好地降低顱內腫瘤患者手術後炎性反應水平,這可能是丙泊酚髮揮腦保護作用的機製之一。
목적：관찰병박분화이불완대로내종류환자염성세포인자[종류배사인자α( TNF-α)、백세포개소1( IL-1)화세포점부분자-1(ICAM-1)]적영향,탐토병박분뇌보호작용궤제。방법로내종류수술환자168례,수궤분위병박분조화이불완조,각84례。병박분조혈장파공수주병박분3~6μg · mL-1,이불완조급여1%~2%이불완지속흡입。환자균우마취유도전、수술후0 h、수술후24 h화수술후48 h추취정맥혈,측정혈청TNF-α、IL-1화ICAM-1적함량。결과량조환자수술후혈청TNF-α、IL-1화ICAM-1함량균정상승추세。수술후24 h,병박분조화이불완조TNF-α분별위(69.11±8.95),(76.26±11.28)μg·mL-1；IL-1분별위(21.57±3.19),(29.58±4.38) ng·L-1；ICAM-1분별위(1.63±0.24),(1.94±0.29) g·L-1；수술후48 h,병박분조염성세포인자함량야균교이불완조강저(P<0.05혹P<0.01)。결론병박분파공수주비이불완흡입가경호지강저로내종류환자수술후염성반응수평,저가능시병박분발휘뇌보호작용적궤제지일。
Objective To explore the neuroprotective mechanism of propofol by comparing the influence of propofol and isoflurane on inflammatory cytokines ( TNF-α、IL-1、ICAM-1 ) in patients with intracranial tumors. Methods One hundred and sixty-eight patients with intracranial neoplasm were randomly divided into two groups:the propofol ( Group P) and isoflurane (Group I),84 cases in each. Patients were given with propofol (3-6 μg·mL-1) by plasma target-controlled infusion or with continuously inhaled isoflurane ( 1%-2%) , respectively. The serum levels of TNF-α, IL-1 and ICAM-1 were detected before anesthesia and at 0,24,and 48 h after operation. Results The serum levels of TNF-α,IL-1 and ICAM-1 were significantly increased after operation as compared to baseline in both groups. The serum level of TNF-α was(69. 11±8. 95) and (76. 26±11.28) μg·mL-1,IL-1 was(21.57±3.19) and (29.58±4.38) ng·L-1,and ICAM-1 was (1.63±0.24)and (1.94±0.29) g·L-1 at 24 h post operation in Group P and Group I,respectively. These inflammatory cytokine levels were significantly higher in group I compared to group P at 24 and 48 h after operation (P<0. 05 or P<0. 01). Conclusion The target-controlled infusion of propofol brings about lower level of inflammatory reaction than isoflurane inhalation in patients with intracranial neoplasm,which may attribute to the mechanism of brain protection against injury.
