异丙酚对脑出血患者血中S-100β蛋白内皮素和肿瘤坏死因子的影响

Effects of propofol on S - 100β protein, ET and TNF in serum in patients with hypertensive cerebral hemorrhage

目的探讨异丙酚对高血压脑出血患者血中S-100β蛋白（S-100β）、内皮素（ET）和肿瘤坏死因子（TNF）的影响，评价异丙酚对高血压脑出血患者脑组织的作用。方法选取高血压脑出血实施颅骨钻孔引流术的患者20例，随机分为2组（n=10）：异丙酚组和对照组。异丙酚组采用利多卡因局部浸润麻醉同时复合静脉持续输注异丙酚5mg／（kg·h），输注时间为1．5h；对照组采用利多卡因局部浸润麻醉同时以相应速度输注生理盐水1．5h。所有患者分别于术前、输注结束、术后1d、术后3d、术后7d采集静脉血，测定血中S-100β、ET和TNF含量。术前和术后7d分别评价Glascow评分。结果两组患者血中S-100β、ET及TNF含量在手术前后5个时间点间差异无统计学意义（P〉0．05）。两组术后7d Glascow评分差异无统计学意义（P〉0．05）。结论对于高血压脑出血患者，应用此麻醉剂量的异丙酚，在持续输注1．5h的情况下，未发现明显的脑保护作用。

Objective To study the effects of propofol on S - 10015 protein, ET and TNF in serum in patients with hypertensive cerebral hemorrhage in order to evaluate the effects of propofol on brain tissue of patients with hypertensive cerebral hemorrhage. Methods 20 patients with hypertensive cerebral hemorrhage, would be performed trephination and drainage treatment, were randomly divided into 2 groups （ n = 10） ： propofol group and control group. Patients in propofol group were performed local anesthesia with lidocaine and received intravenous propofol infusion at 5 mg/（ kg ·h） for 1. 5 h meanwhile, patients in control group were performed local anesthesia with lidocaine and infused 0.9% saline with corresponding volume at the meantime. The serum levels of S - 100β protein, ET and TNF were then detected by RIA at preoperative moment, the moment after 1.5 h infusion and day 1 ,day 3 ,day 7 after operation. Glascow coma scales were evaluated at preoperative moment and 7 days after operation. Results There were no obvious differences between the two groups in the serum S - 100β protein, ET and TNF at any time point while blood sample was collected. And there was also no difference in Glascow scale between two groups in the day 7 after operation. Conclusion This therapeutic dosage of propofol infused in vein for 1.5 h may not provide obvious neuroprotective to patients with hypertensive cerebral hemorrhage.