甘露醇对胃癌根治术患者吸入高浓度氧时的抗氧化作用

The antioxidant effects of mannitol during inhalation of high concentration of oxygen

目的 评价甘露醇对胃癌根治术患者吸入高浓度氧时的抗氧化作用。方法 ASAⅠ或Ⅱ级胃癌根治术患者30例，随机分为3组（n=10），吸入高浓度氧组（I组）麻醉诱导后吸入高浓度氧（98％～99％）；吸入低浓度氧组（Ⅱ组）麻醉诱导后吸入40％氧气；吸入高浓度氧复合甘露醇组（Ⅲ组）麻醉诱导后吸入高浓度氧，同时静脉输注甘露醇0．3g·kg^-1·h^-1 4h。在麻醉诱导前即刻、插管后1、2、3、4h抽桡动脉血，检测血清超氧化物歧化酶（SOD）活性、丙二醛（MDA）浓度和总抗氧化能力（TAC）。结果 与Ⅱ、Ⅲ组比较，Ⅰ组SOD活性明显降低，MDA浓度明显升高（P〈0．05）；与诱导前即刻比较，Ⅰ组插管后4hTAC明显降低（P〈0．05）；Ⅱ、Ⅲ组插管后4h内TAC无明显下降（P〉0．05）。结论 静脉持续输注甘露醇对胃癌根治术患者全麻期间吸入高浓度氧时可产生明显的抗氧化作用，患者机体的抗氧化能力稳定。

Objective To investigate the effects of mannitol on the changes in serum superoxide dismutase （SOD） activity, malondialdehyde （MDA） concentration and total antioxidant capacity （TAC） during inhalation of high concentration of oxygen in patients undergoing radical gastrectomy. Methods Thirty ASA Ⅰ or Ⅱ patients of both sexes aged 26-64 yrs weighing 46-75 kg undergoing radical gastrectomy were randomly divided into 3 groups （ n = 10 each） ： group Ⅰ inhaled 98%-99% O2 after induction of anesthesia; group Ⅱ inhaled 40% 02 and group Ⅲ inhaled 98%-99% 02 ＋ Ⅳ infusion of mannitol （0.3 g·kg^-1· h^-1 ）. Arterial blood samples were taken immediately before induction of anesthesia （baseline） and at 1, 2, 3 and 4 h after tracheal intubation for determination of serum SOD activity, MDA concentration and TAC. Results （ 1 ） SOD activity was significantly decreased at 2, 3, 4 h after tracheal intubation as compared with the baseline in group Ⅰ and Ⅱ （ P 〈 0.05） and was significantly higher at 3 h and 4 h after tracheal intubation in group Ⅱ and Ⅲ than in group Ⅰ （ P 〈 0.05 ）. （2） MDA level was significantly increased at 3 and 4 h after tracheal intubation as compared with baseline in group Ⅰ （ P 〈 0.05） and was significantly lower at 4 h after tracheal intubation in group Ⅱ and Ⅲ than in group Ⅰ （ P 〈 0.05）. （3） TAC was significantly decreased at 4 h after tracheal intubation as compared with the baseline in group Ⅰ （ P 〈 0.05）, but no significant change in TAC was observed before and during 4 h after tracheal intubation in group Ⅱ and Ⅲ . Conclusion Mannitol infusion has antioxidant effect during inhalation of high concentration of oxygen.