围术期持续输注小剂量异丙酚对房或室间隔缺损修补术患儿心肌的保护作用

Protective Effect of Low Dose Propofol Injection on Myocardium During the ASD or VSD Neoplasty in Pediatric Patients

目的:观察围术期持续输注小剂量异丙酚对房或室间隔缺损修补术患儿心肌的保护作用。方法:40例择期行房或室间隔缺损修补术的患儿,随机分成两组(n=20):异丙酚组和对照组。异丙酚组在麻醉诱导后靶控持续小剂量输注异丙酚0.5 mg.kg-1.h-1至术后4 h。分别在术前、开放主动脉后1 h、术后24 h、48 h从中心静脉采取血样,测定肌酸磷酸激酶(CK)、肌酸磷酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平。结果:与术前比较,开放主动脉后1 h、术后24 h、48 h两组患者血清CK、CK-MB、cTnI、MDA均升高(P<0.05),SOD降低(P<0.05)。与对照组比较,在开放主动脉后1 h、术后24、48 h时,异丙酚组血清CK、CK-MB、cTnI、MDA均降低(P<0.05),SOD升高(P<0.05)。结论:围术期持续输注小剂量异丙酚对房或室间隔缺损修补术患儿有良好的心肌保护作用。

Objective To investingate the protective effect of low dose propofol injection on myocardium during the atrial septal defect （ASD） or ventricular septal defect （VSD） neoplasty in pediatric patients. Methods Forty patients with ASD or VSD for 1 - 10 years were randomly divided into two groups （ n = 20） ：propofol group and control group. Patients were received the same anesthetic management during the operation while the patients in propofol group were treated with 0.5 nag·kg - 1· h - 1 propofol before the operation and up to 4 hs after the operation. Blood was collected to assay the level of creatine kinase（CK）, creatine kinase MB isoenzyme（ CK- MB） with automatic biochemistry analyzer and cardiac troponin I（ cTnI） , superoxide dismutase（SOD） , malondialdehyde（MDA） by ELISA at preoperation, 1 h after opening aorta,and 24 h, and 48 h after postoperation. Results The level of CK,CK- MB,cTnI and MDA of all patients were significantly higher （P 〈 0.05 ）, while the level of SOD was lower （ P 〈 0.05 ） at the other time points than that in preoperation. The level of CK, CK- MB ,cTnI and MDA in propofol group was significantly lower, while the level of SOD was higher than that in control group at the other three time points except preoperation. Conclusion A low dose propofol injection during the ASD and VSD neoplasty in pediatric patients can provide the protective effect on myocardium.