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岭南现代临床外科 ›› 2020, Vol. 20 ›› Issue (03): 338-340.DOI: 10.3969/j.issn.1009-976X.2020.03.016

• 论著与临床研究 • 上一篇    下一篇

乌司他丁对幕上肿瘤切除术患者颈内静脉球部血清SOD和MDA含量的影响

刘世乐, 周翠云, 袁友红, 骆成磊, 陈汉文, 唐淑仪, 邢祖民*   

  1. 南方医科大学顺德医院麻醉科,广东佛山 528308
  • 通讯作者: *邢祖民,Email: 13923260368@163.com

The effect of Ulinastatin on the concentration of SOD and MDA in patients undergoing supratentorial tumor resection

LIU Shi-le, ZHOU Cui-yun, YUAN You-hong, LUO Cheng-lei, CHEN Han-wen, TANG Shu-yi, XING Zu-min   

  1. Department of Anesthesiology, Shunde Hospital of Southern Medical University ,Foshang, Guangdong 528300, China
  • Received:2020-03-10 Online:2020-06-20 Published:2020-06-20
  • Contact: XING Zu-min, 13923260368 @163.com

摘要: 目的 观测乌司他丁对幕上肿瘤切除术患者颈内静脉球部血清超氧化物歧化酶(SOD)、丙二醛(MDA)含量的影响。方法 择期行幕上肿瘤切除术患者24例,年龄18~55岁,ASAⅠ~Ⅱ级。随机数字表法分为对照组(A组,12例)、乌司他丁组(U组,12例),U组在切皮时予2 kU/kg乌司他丁静脉推注,随后予1 kU·kg-1·h-1泵注至术毕。A组于相同一时点输入等量0.9%生理盐水。分别全麻诱导前(T1)、切皮前(T2)、切硬脑膜后1 h(T3)、缝硬脑膜时(T4)手术结束(T5)、术后24 h(T6)6个时点同步采集颈内静脉球部血,采用改良盐酸羟胺法和TAB荧光法测定SOD、MDA含量。结果 SOD活性T3~T6均较T1显著下降(P<0.001),MDA含量T3~T6均较T1显著上升(P<0.001),SOD活性U组T3~T6高于A组(P<0.001),MDA含量U组T3~T6较 A组显著降低(P<0.001)。结论 乌司他丁能提高患者术中、术后24 h内血清SOD活性,降低MDA含量,抗脂质过氧化反应是其发挥脑保护作用的机制之一。

关键词: 乌司他丁, 超氧化物歧化酶, 脑保护, 幕上肿瘤切除术, 丙二醛

Abstract: Objective To observe the concentration of superoxide dismutase (SOD), malondialdehyde (MDA) in patients undergoing supratentorial tumor resection with Ulinastatin treatment. Methods 24 patients with supratentorial tumor resection,aged between 18 and 55 yeas old, ASAⅠorⅡ, were randomly divided into the control group (group A, n=12) and Ulinastatin groups (group U, n=12). Patients in Group U received Ulinastatin (2 kU/kg) at the beginning of the surgery, with the continuous dose of 1 kU·kg-1·h-1 till the end of the operation. Group A received equivalent volume of saline solution as the vehilcle control. Blood samples were taken from the artery and jugular venous bulb before induction of anesthesia (T1), skin incision (T2),1 h after dura openning (T3), at the closure of dura (T4), at the end of operation (T5)and 24 h after operation (T6) to analysis the concentration of superoxide dismutase (SOD) andmalondialdehyde (MDA). The concentration of superoxide dismutase (SOD), malondialdehyde (MDA) were determined by improved hydroxylamine hydrochloride method and TAB fluorescence method. Results The concentration of serum MDA were more dramatic rise at T3-T6 than at T1 in both groups. The concentration of serum SOD were more dramatic decline at T3-T6 than at T1 in both groups. The concentration of SOD and MDA increasd and decreased significantly at T3-T6 in group U than that in group A (P<0.001). Conclusion Ulinastatin can improve the concentration of serum SOD and decrease MDA during surgery, which indicates the alleviating for the brain injury during supratentorial tumor resection.

Key words: malondialdehyde, supratentorial tumor resection, ulinastatin, superoxidedismutase, cerebral protection

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