山东医药
山東醫藥
산동의약
Shandong Medical Journal
2015年
41期
4-6
,共3页
孙雪梅%王瑞婷%贺克强%章蔚%柴小青%潘建辉
孫雪梅%王瑞婷%賀剋彊%章蔚%柴小青%潘建輝
손설매%왕서정%하극강%장위%시소청%반건휘
七氟醚%心肺转流术%NF-E2相关因子2%心肌钙蛋白I%氧化应激
七氟醚%心肺轉流術%NF-E2相關因子2%心肌鈣蛋白I%氧化應激
칠불미%심폐전류술%NF-E2상관인자2%심기개단백I%양화응격
sevoflurane%cardiopulmonary bypass%NF-E2-related factor 2%cardiac troponin I%oxidative stress
目的 观察七氟醚预处理对心肺转流术( CPB)下心脏瓣膜置换术患者血清中cTnI和外周血单核细胞( PBMC)核蛋白Nrf2表达的影响,探讨其对心肌的保护作用和机体氧化应激的影响.方法 选择择期CPB下行心脏瓣膜置换术患者30例,随机分为未吸入七氟醚对照组( C组)和七氟醚预处理组( S组) ,每组15例. S组切皮至主动脉阻断前吸入1.0%七氟醚20 min,随后予以10 min洗脱期,如此重复2次. 于麻醉诱导前( T1 )、主动脉开放后2 h( T2 )、24 h( T3 )和48 h( T4 )采集动脉血,检测血清cTnI水平、MDA水平和SOD活性;于T1 和T3 用Western blotting检测外周血PBMC核蛋白Nrf2表达水平;MDA水平、SOD活性与Nrf2蛋白表达水平进行直线相关性分析.结果 与术前比较,T2~4时两组血清中cTnI浓度均明显升高(P均<0.05),但S组明显低于C组(P均<0.05).与术前比较,T3 时两组PBMC核蛋白Nrf2表达均显著升高(P均<0.05),但S组明显高于C组(P均<0.05). 与C组比较,T2~4时血清MDA水平降低,SOD活性升高( P<0.05). MDA水平、SOD活性均与Nrf2蛋白表达具有相关性(r分别为-0.694、0.739,P均<0.05). 结论 七氟醚预处理可以减轻CPB下心脏瓣膜置换术患者心肌损伤,减弱体内氧化应激反应,以上作用可能与增强Nrf2蛋白的表达有关.
目的 觀察七氟醚預處理對心肺轉流術( CPB)下心髒瓣膜置換術患者血清中cTnI和外週血單覈細胞( PBMC)覈蛋白Nrf2錶達的影響,探討其對心肌的保護作用和機體氧化應激的影響.方法 選擇擇期CPB下行心髒瓣膜置換術患者30例,隨機分為未吸入七氟醚對照組( C組)和七氟醚預處理組( S組) ,每組15例. S組切皮至主動脈阻斷前吸入1.0%七氟醚20 min,隨後予以10 min洗脫期,如此重複2次. 于痳醉誘導前( T1 )、主動脈開放後2 h( T2 )、24 h( T3 )和48 h( T4 )採集動脈血,檢測血清cTnI水平、MDA水平和SOD活性;于T1 和T3 用Western blotting檢測外週血PBMC覈蛋白Nrf2錶達水平;MDA水平、SOD活性與Nrf2蛋白錶達水平進行直線相關性分析.結果 與術前比較,T2~4時兩組血清中cTnI濃度均明顯升高(P均<0.05),但S組明顯低于C組(P均<0.05).與術前比較,T3 時兩組PBMC覈蛋白Nrf2錶達均顯著升高(P均<0.05),但S組明顯高于C組(P均<0.05). 與C組比較,T2~4時血清MDA水平降低,SOD活性升高( P<0.05). MDA水平、SOD活性均與Nrf2蛋白錶達具有相關性(r分彆為-0.694、0.739,P均<0.05). 結論 七氟醚預處理可以減輕CPB下心髒瓣膜置換術患者心肌損傷,減弱體內氧化應激反應,以上作用可能與增彊Nrf2蛋白的錶達有關.
목적 관찰칠불미예처리대심폐전류술( CPB)하심장판막치환술환자혈청중cTnI화외주혈단핵세포( PBMC)핵단백Nrf2표체적영향,탐토기대심기적보호작용화궤체양화응격적영향.방법 선택택기CPB하행심장판막치환술환자30례,수궤분위미흡입칠불미대조조( C조)화칠불미예처리조( S조) ,매조15례. S조절피지주동맥조단전흡입1.0%칠불미20 min,수후여이10 min세탈기,여차중복2차. 우마취유도전( T1 )、주동맥개방후2 h( T2 )、24 h( T3 )화48 h( T4 )채집동맥혈,검측혈청cTnI수평、MDA수평화SOD활성;우T1 화T3 용Western blotting검측외주혈PBMC핵단백Nrf2표체수평;MDA수평、SOD활성여Nrf2단백표체수평진행직선상관성분석.결과 여술전비교,T2~4시량조혈청중cTnI농도균명현승고(P균<0.05),단S조명현저우C조(P균<0.05).여술전비교,T3 시량조PBMC핵단백Nrf2표체균현저승고(P균<0.05),단S조명현고우C조(P균<0.05). 여C조비교,T2~4시혈청MDA수평강저,SOD활성승고( P<0.05). MDA수평、SOD활성균여Nrf2단백표체구유상관성(r분별위-0.694、0.739,P균<0.05). 결론 칠불미예처리가이감경CPB하심장판막치환술환자심기손상,감약체내양화응격반응,이상작용가능여증강Nrf2단백적표체유관.
Objective To observe the effect of sevoflurane preconditioning on serum cTnI and the nuclear factor ery-throid 2-related factor 2( Nrf2) expression in peripheral blood mononuclear cells ( PBMCs) of patients undergoing cardiac valve replacement with CPB, and to investigate its influence on the myocardial protection and oxidative stress of body. Methods In this randomized controlled trial, thirty patients who received valve replacement were randomly divided into two groups (n=15): the control group (group C) and sevoflurane preconditioning group (group S).In the group S, 1.0%sevoflurane was inhaled for 20 min from skin incision, and followed with oxygen elution for 10 min, it repeated twice.The artery blood samples were collected for the measurements of serum concentrations of cTnI, MDA and SOD im-mediately before anesthesia induction ( T1 ) , at 2 h ( T2 ) , 24 h ( T3 ) and 48 h ( T4 ) after aorta declamping respectively. The expression of Nrf2 protein from PBMC was detected by Western blotting at T1 and T3 .Linear correlation between the expression of Nrf2 protein and MDA concentration, SOD activity was analyzed.Results Compared with that before opera-tion, the concentration of serum cTnI was increased significantly in both groups(P<0.05) at T2-4.However, it was much lower in the group S than in the group C(P<0.05).The expression of Nrf2 protein in PBMC was increased significantly in both groups at T3 as compared with that before operation (P<0.05).However, it was much higher in the group S than in the group C (P<0.05).Compared with group C, the serum MDA concentration was decreased, while SOD activity was significantly higher at T2-4 in the group S (P<0.05).There was linear correlation between the expression of Nrf2 protein and MDA concentration, SOD activity (r=-0.694 and 0.739, all P<0.05).Conclusion Sevoflurane preconditioning can alleviate myocardial injury and reduce oxidative stress injury in patients undergoing cardiac valve replacement with CPB, which might be associated with the increased Nrf2 expression.