小剂量丙泊酚静脉注射对选择性冠状动脉造影患者血浆炎症因子的影响研究

Effects of low-dose propofol on inflammatory cytokines in patients undergoing selective coronary angiography

目的探讨术前小剂量丙泊酚静脉注射对选择性冠状动脉造影检查患者血浆炎症细胞因子的影响。方法拟诊稳定性心绞痛行冠状动脉造影的162例患者随机分为丙泊酚组和对照组;丙泊酚组术前给予一次性静脉注射丙泊酚5mg,对照组注射生理盐水5mg;分别测定两组术前及术后24小时外周静脉血CRP、IL-6、TNF-α水平。结果丙泊酚组术后CRP水平较术前差异无统计学意义(P>0.05),术后IL-6水平较术前明显下降(25.662±8.916)pg/ml比(36.714±16.336pg/ml);对照组患者术后CRP水平较术前明显上升(3.2±1.2)mg/L比(2.5±1.3)mg/L,术后IL-6水平较术前明显上升(36.689±11.684)pg/ml比(33.168±10.027)pg/ml;两组术后TNF-α水平较术前均没有显著改变。结论冠状动脉造影术可引起血浆炎症因子的升高,小剂量丙泊酚静脉注射可明显减轻选择性冠状动脉造影患者术后血浆炎症因子的水平。

Objective To investigate the effects of low-dose propofol on inflammatory cytokines in patients undergoing coronary angiography.Methods One hundred and sixty two patients diagnosed with stable angina undergoing selective coronary angiography were enrolled in the study.Patients were randomized into the propofol group （n=85） and the control group （n=77）.The propofol group was given 5mg propofol while 5mg normal saline was given to the control group by intravenous injection before angiogram.CRP,IL-6 and TNF-α levels were measured in peripheral blood samples collected before and 24 hours after the procedure.Results There was no significant change in CRP levels after the procedure in the propofol group（P〉0.05） but there was a significant decrease in IL-6 levels after the procedure in the propofol group when compared with the pre-procedure levels （25.662±8.916 pg/ml vs.36.714±16.336 pg/ml,P〈0.001）.In the control group,the levels of CRP concentrations increased significantly （3.2±1.2 mg/L vs.2.5±1.3 mg/L,P〈0.05） and also the levels of IL-6 （36.689±11.684 pg/ml vs.33.168±10.027 pg/ml,P〈0.05）after the procedure.There were no differences in the levels of TNF-α before and after the procedure in all patients （P〉0.05）.Conclusion Coronary angiography triggers a systemic inflammatory response in patients undergoing selective angiography,but low-dose propofol can alleviate the inflammatory response to coronary angiography.