异丙酚麻醉对清除急性颅脑损伤病人氧自由基作用的观察

The Effects of Propofol on Eliminating OFR in Patients with Brain Trauma During Neurosurgical Treatment

研究急性颅脑损伤患者手术期间静脉麻醉剂异丙酚体内的抗氧化特性及脑保护作用。严重颅脑伤(GCS≤8分)后6小时内人院患者30例,随机分为观察组(异丙酚组15例,A组)和对照组(γ-羟基丁酸钠组15例,B组)。测定血浆氧自由基(OFR)及血浆脂质过氧化物(LPO)含量。结果发现:麻醉1小时后两组OFR、LPO较术前明显升高(P<0.01,P<0.01),对照组升高更显著。麻醉3小时观察组OFR、LPO较麻醉1小时显著降低(P<0.01,P<0.01),而对照组OFR、LPO较麻醉1小时仍显著升高(P<0.01,P<0.01)。相应时间组间比较有显著性差异(P<0.01)。表明:急性颅脑损伤患者机体自由基代谢增强,开颅手术可引起继发性脑缺血再灌注损伤,临床麻醉剂量的异丙酚可直接清除体内OFR而具有脑保护作用。

To study the antioxidation properties in vivo and the effect of cerebral protective effect of propofol during neurosurgical treatment of acute brain trauma. Methods: 30 cases were divided randomly into group A(Propofol, n = 15) and group B(r-OH, n = 15) as control. Using electron spin resonance (ESR)spectroscopy method to measure plasma oxygen free radical(OFR)and biochemical method to measure the plasma lipid peroxide(LPO). Result:The results showed that the basic OFR and LPO of all patients were significantly higher than the normal levels before operation(P< 0.01). In both groups the OFR and LPO were signigicantly increased after one hour of neurosurgery than those before operation (P <0.01).The increase in control group was more marked. Compared with the control,OFR and LPO in propofol group were significantly decreased three hours after neurosurgical treatment(P<0.01).But two indexes in control group were significantly increased(P<0.01)relatively. Conclusion: It is concluded that OFR metabolism may enhance in patients with acute brain trauma. Therapeutic doses of propofol may play a role in brain protection and act as an OFR scavenger in vivo.