丙泊酚麻醉对急性颅脑外伤手术患者血清S100B的影响

The effect of propofol on serum concentration of S100B in patients undergoing neurosurgery

目的研究急性颅脑外伤手术前和手术期间丙泊酚对血清S100B的影响,以评价丙泊酚的脑保护作用。方法急症颅脑外伤手术患者30例。随机分为丙泊酚(A)组和异氟醚(B)组,每组15例。另10例泌尿系统手术的非颅脑损伤患者的血清作空白对照(C)组。酶联免疫吸附法测定C组及A、B组颅脑手术前、手术开始2h、手术结束时血清S100B含量。对急症颅脑外伤手术患者进行格拉斯哥(Glasgow)评分。结果A、B组患者手术前S100B显著高于C组(P<0·01);Glasgow评分越低的患者术前S100B越高(r=-0.446,P<0·05)。手术结束时A组S100B显著低于B组(P<0·05)。开颅手术2h和手术结束时两组S100B均较术前有升高。结论急性颅脑外伤时患者血清S100B升高,Glasgow评分越低,血清的S100B浓度也越高。提示临床剂量丙泊酚可以抑制血清S100B的升高,减轻继发性脑损害,具有脑保护作用。

Objective To investigate the effect of propofol on serum concentration of S100B in patients undergoing neurosurgery. Methods Ten patients undergoing urinary operation without cerebral injury were taken as control group（C）. Thirty patients with brain injury were randomly divided into propofol group （A） and isoflurane group （B） with 15 cases each. The serum concentration of S100B was measured by enzyme-linked immunoadsordent assay before operation, at 2 h of operation and the end of operation. Glasgow score of cerebral injured patients were estimated. Results Preoperation serum concentration of S100B in group A and B was significantly higher than that in group C （P〈0.01）. Glasgow score was significantly negatively with the S100B serum concentration （r=-0. 446,P〈0.05）. The serum concentration of S100B in group A was significantly lower than that in group B at the end of operation（P〈0.05）. The serum concentration of S100B at 2 h and the end of operation was higher than that before operation. Conclusion The serum concentration of S100B increased in cerebral injured patient, which was negatively correlated with Glasgow score. The anesthesia dose of propofol may have cerebral protective effect by reducing the increase of serum concentration of S100B in patients undergoing neurosurgery.