摘要
目的在颅内动脉瘤夹闭术前对患者进行缺氧预处理(HPC)干预,观察患者血清脑红蛋白(neuroglobin,NGB)、S-100B蛋白表达的变化,以探讨HPC与血清NGB、S-100B蛋白相关的保护效应机制和可能的临床意义。方法采用随机对照的方法纳入符合标准的40例拟行颅内动脉瘤夹闭术的患者,分为HPC组(A组,n=20)和对照组(B组,n=20)。A组采用重复3次的脱氧复氧方式进行HPC,记录每次缺氧耐受时间及各时刻生命体征,并在每次干预结束后和术中相应时刻抽取动静脉血,以进行血气分析和检测血清NGB、S-100B蛋白的含量。结果在HPC过程中,A组出现轻度缺氧和CO2蓄积,CO2蓄积程度随缺氧次数的增加而加重(P<0.05),而缺氧状态却随之逐渐缓解(P<0.05)。血清NGB在T2~T4时刻(第3次复氧结束时、颅骨打开动脉瘤夹闭前、动脉瘤夹闭并关闭脑膜后),A组表达高于B组(P<0.05),而血清S-100B两组各时刻无明显差异(P>0.05)。结论 HPC对机体造成一定程度的生理干扰,但也启动了机体强大的代偿能力,激发了NGB表达上调,增加了机体对缺氧耐受的能力。
Objective To study the clinical effects of hypoxia preconditioning(HPC)and its effects on serum neuroglobin(NGB)and S-100Blevel in the patients undergoing intracranial aneurysm surgery.Methods Forty patients scheduled to intracranial aneurysm surgery were randomly divided into 2 groups:HPC group(n=20)and control group(n=20).The patients in HPC group were treated with 3 cycles of deoxidation-reoxygenation after intubation.The time of deoxidation in each HPC cycle was recorded,while vital signs were also recorded in each corresponding time point.Blood samples were obtained from exsanguinate radial artery and jugular bulb section at the end of each HPC cycle and corresponding time points during operation to measure serum level of NGB and S-100B protein and to analysis blood gas.Results During HPC process,the patients in group HPC experienced mild hypoxia and CO2 retention.With the times of HPC increasing,CO2 retention degree became heavier(P<0.05)while hypoxia improved,the patients need more time to make SpO2 from 100% to 90%(P<0.05).From T2 to T4(the end of the third reoxygenation,during skull opened and aneurysm dipped,skull closed),NGB in group HPC was higher than that in control(P<0.05),but S-100Blevel was not different between HPC and control group(P>0.05).Conclusion HPC could induce compensatory ability of the body to hypoxia,which might be related to the up-regulation of NGB expression.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2013年第5期747-751,755,共6页
Journal of Sichuan University(Medical Sciences)
