[参附注射液预处理对体外循环下主动脉瓣置换术患者脑的保护作用]

[Protective effect of shenfu injection pretreatment on brain of patients receiving aortic valve replacement undergoing cardiopulmonary bypass].

作者信息

Deng Chao, Dai Zhi-Gang, Chen Yong-Jin, Dong Xi-wei

机构信息

Department of Anesthesiology, First Affiliated Hospital, Medical College of Shihezi University, Xinjiang 832000, China.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2013 May;33(5):602-5.

PMID:23905375

Abstract

OBJECTIVE

To observe the protective effect of Shenfu Injection (SFI) pretreatment on brain of patients receiving aortic valve replacement (AVR) undergoing cardiopulmonary bypass (CPB).

METHODS

Thirty AVR patients undergoing CPB were randomly assigned to 2 groups, the control group and the experimental group, 15 cases in each group. SFI at 1.5 mL/kg (dissolved in 250 mL 5% glucose solution) was intravenously dripped to those in the experimental group 5 days before operation, once daily for 5 successive days. SFI at 1.5 mL/kg (dissolved in 250 mL 5% glucose solution) was intravenously dripped to those 30 min before anesthesia induction. Equal dose of normal saline was intravenously dripped to those in the control group, and the other procedures were the same as those for patients in the experimental group. The venous blood sample (2 mL) was drawn from the right internal carotid vein immediately after induction of anesthesia (T1),10 min after CPB (T2), 30 min after GPB (T3), 2 h after CPB (T4), 24 h after CPB (T5), and 48 h after CPB (T6), thus detecting the plasma levels of S100beta and neuron specific enolase (NSE). And patients' cognitive function was assessed with mini-mental state examination (MMSE) scale on the day before operation, the 2nd and the 7th day after operation.

RESULTS

There was no statistical difference in the levels of S1001 and NSE between the two groups at T1 (P > 0.05). There was statistical difference in the levels of S100beta and NSE between the two groups at T2, T3, T4, T5, T6, when compared with those at T1 (P <0.05). Besides, the levels of S100beta and NSE at T2, T3, T4, T5, T6 were lower in the experimental group than in the control group, showing statistical difference (P <0.05). The MMSE scores decreased on the 2nd day after operation in the two groups, showing statistical difference when compared with those on the day before operation (P <0.05). It was lowered more obviously in the control group. There was no statistical difference in the MMSE score between the 7th day post-operation and the day before operation (P >0.05).

CONCLUSION

SFI pretreatment had protective effect on brain in AVR patients undergoing CPB.

摘要

目的

观察参附注射液（SFI）预处理对接受体外循环（CPB）下行主动脉瓣置换术（AVR）患者脑的保护作用。

方法

30例接受CPB的AVR患者随机分为2组，即对照组和实验组，每组15例。实验组患者于术前5天静脉滴注1.5 mL/kg的SFI（溶于250 mL 5%葡萄糖溶液），每日1次，连续5天。于麻醉诱导前30分钟静脉滴注1.5 mL/kg的SFI（溶于250 mL 5%葡萄糖溶液）。对照组静脉滴注等量生理盐水，其他操作与实验组患者相同。于麻醉诱导后即刻（T1）、CPB后10分钟（T2）、CPB后30分钟（T3）、CPB后2小时（T4）、CPB后24小时（T5）及CPB后48小时（T6）从右颈内静脉采集静脉血样本（2 mL），检测血浆S100β和神经元特异性烯醇化酶（NSE）水平。并于术前、术后第2天和第7天采用简易精神状态检查表（MMSE）对患者认知功能进行评估。

结果

两组在T1时S100β和NSE水平无统计学差异（P>0.05）。两组在T2、T3、T4、T5、T6时S100β和NSE水平与T1时相比有统计学差异（P<0.05）。此外，实验组在T2、T3、T4、T5、T6时S100β和NSE水平低于对照组，差异有统计学意义（P<0.05）。两组术后第2天MMSE评分均降低，与术前相比差异有统计学意义（P<0.05）。对照组降低更明显。术后第7天MMSE评分与术前相比无统计学差异（P>0.05）。