丙泊酚对止血带诱导的缺血-再灌注损伤患者血浆循环内皮细胞和血管性假血友病因子的影响

Effects of propofol on serum circulating endothelial cell and vWF in patients underwent limb ischemia-reperfusion injury

目的探讨丙泊酚靶控输注(TCI)对止血带引起的下肢缺血-再灌注损伤患者血浆循环内皮细胞(CEC)和血管性假血友病因子(vWF)的影响。方法30例下肢需止血带术患者随机均分为Pro组和Iso组。Pro组采用丙泊酚TCI维持麻醉,Iso组则吸入异氟醚维持麻醉。分别于术前(缺血前T0)、放气后30min(T1)、60min(T2)、90min(T3)、术后1d(T4)五个时点抽股静脉血测定血浆CEC和vWF含量。结果两组血浆CEC和vWF含量在T1～T4时均显著高于T0时(P<0.05)。两组T1～T4血浆CEC和vWF比较差异均有统计学意义(P<0.05)。结论丙泊酚TCI可减少止血带引起的下肢缺血-再灌注损伤患者血浆CEC和vWF的含量,对血管内皮细胞具有保护作用。

Objective To study the protective effect of propofol on the circulating endothelial cell （CEC） acute injury and yon Willebrand factor（vWF） in the patients underwent limb tourniquetinduced ischemia-reperfusion（I-R） injury. Methods Thirty patients undergoing limb operation were divided into two groups with 15 cases each. The anesthesia was maintained with target controlled infusion（TCI） of propofol in group Pro or isoflurane inhalation in group Iso. Blood samples were withdrawn for detecting the levels of endothelin（ET） and vWF before skin incision（T0 ） ,and at 30 min （T1）,60 min（T2）,90 rain（T3）,24 hours（T,） after loosing tourniquets. Results The levels of CEC and vWF in both groups were significantly higher at T1 to T4 than those at To （P〈0. 05） ,which were significantly lower in group Pro than those in group Iso at T1 to T4 （P〈0. 05）. Conclusion Propofol has protective effects on tourniquet-induced limb I-R injury through inhibiting the increase of ET and vWF.