依达拉奉对体外循环下冠脉搭桥术患者血浆S100-B蛋白水平的影响

Effect of edaravone on the off-pump coronary artery bypass surgery in patients with serum S100-B protein levels and its mechanism

目的探讨依达拉奉对体外循环下冠脉搭桥术患者血浆S100-B蛋白水平的影响及其机制。方法选择行体外循环下冠脉搭桥术术患者30例,随机分为实验组(n=15),对照组(n=15)。实验组依达拉奉0.5mg/kg在麻醉诱导后5min静脉滴注及另外0.5mg/kg于主动脉开放前5min加入体外循环机内;对照组则不用依达拉奉。两组分别于麻醉诱导后5min(T1)、主动脉开放后5min(T2)、手术结束后1h(T3)、2h(T4)、6h(T5)和24h(T6),采集患者颈内静脉血,检测血清S-100蛋白。结果两组S-100蛋白在T2～5时间段高于T1(P<0.01);实验组S-100蛋白浓度在T2-5时间段低于对照组(P<0.05或0.01)。结论依达拉奉可减轻体外循环(CPB)下冠脉搭桥术患者的脑损伤,其机制可能与其通过血脑屏障,有效清除自由基和抑制脂质过氧化的作用,抑制脑细胞的过氧化作用减轻脑缺血和脑缺血引起的脑水肿有关。

Objective To explore the offect of edaravone on the off-pamp cordnary artery its me chanism. line off-pump coronary artery bypass graft surgery in 30 patients,randomly divided into experimental group （n=15）, the control group （n=15）. Experimental group,edaravone 0.5 mg/Kg at 5 min after induction of anesthesia , intravenous infusion and another 0.5 mg/kg by adding at 5 min before aortic bypass machine; the control group without edaravone. Two groups after induction of anesthesia,respectively,5 min （T1）,after the opening of the aorta 5 min （T2）,after surgery,1 h （T3）,2 h （T4）,6 h （T5） and 24 h （T6）,jugular venous blood collected in patients ,serum S-100 protein. Result S-100 protein of both group in T2～T5 were higher than that in T1 （P 0.01）,consentration of S-100 protein in experimental group was lower than control group was lower than control group cluring T2～T5 （P 0.05）（P 0.01） Conclusion Edaravone reduces cardiopulmonary bypass （CPB） in patients with coronary artery bypass surgery under the brain injury,its mechanism may be related through blood-brain barrier , effectively scavenging free radicals and inhibiting lipid peroxidation,inhibition of brain cells over oxidation of cerebral ischemia and cerebral ischemia-induced brain edema.