α-硫辛酸对糖尿病患者体外循环手术后脑损伤的影响

Effects of α-lipoic acid on cerebral neurologic injuries during cardiopulmonary bypass surgery in diabetes patients

目的观察抗氧化剂α-硫辛酸对糖尿病患者体外循环(CPB)术后脑损伤的影响。方法选择行心脏瓣膜瓣置换术的糖尿病患者36例,随机分为实验组和对照组,各18例。实验组在麻醉诱导前静滴α-硫辛酸600 mg,对照组静滴等量NS。分别于CPB开始前(T1)、CPB开始后30 min(T2)、CPB结束时(T3)及CPB结束后1(T4)、2(T5)、6 h(T6)采集患者颈内静脉血,用ELISA法检测血清S100β蛋白和神经元特异性烯醇化酶(NSE)水平。结果CPB开始后即有血清S100β蛋白和NSE水平升高,相同时点实验组血清S100β蛋白和NSE水平明显低于对照组。结论α-硫辛酸能明显减少糖尿病患者手术时血清S100β蛋白和NSE水平,对CPB造成的脑损伤有保护作用。

Objective To investigate the effect of α-lipoieacid on cerebral neurologic injuries during cardiopulmonary bypass（CPB） surgery in diabetes patients. Methods 36 diabetes patients undergoing mitral or aortic valve replacement （ MVR or AVR） with CPB were randomly divided into control group（ group C, 18 cases） and experiment group（ group E, 18 cases）. In group E, 600 mg α-lipoic acid was given by intravenous injection before anesthesia induction,while in group C only equivalent of normal saline was administration. Blood samples were taken from intrajugular vein serum levels of S100β protein, neuron-specific enolase（NSE） were determinated by ELISA at six time-points：before the start of CPB, after 30 min following CPB,at the end of CPB and 1,2 and 6 h after CPB termination. Results Serum levels of S100β and NSE at the end of CPB were higher than those after 30 min following CPB in both groups, but the levels in group E were significantly lower than those in group C at the same stage（P 〈0.01 ）. Conclusions α-lipoicaeid can attenuate serum S100β and NSE and prevent cerebral neurologie injury daring cardiac valve replacement in diabetes patients.