七氟烷对术前化疗患者心肌细胞的影响

Sevoflurane does not aggravate myocardial injury induced by preoperative chemotherapy

目的评价七氟烷对术前化疗患者心肌细胞的影响。方法择期拟行乳腺癌根治术全麻患者30例,ASAⅠ或Ⅱ级,依据术前是否化疗,分为化疗组(S组)15例和未化疗组(C组)15例,于麻醉前(T_0)、手术结束(T_1)、术后24h(T_2)、术后48h(T_3)时抽取患者颈内静脉血检测并比较血清肌酸肌酶(CK-MB)、心肌肌钙蛋白l(cTnl)和N端B型脑钠肽(NT-proBNP)水平。结果两组患者各时点CK-MB水平差异无统计学意义(P>0.05),与C组比较,S组各时点cTnl、NT-proBNP水平升高(P<0.05)。两组内比较,与T_0时刻相比,T_1、T_2、T_3时刻cTnl和NT-proBNP水平差异均无统计学意义(均P>0 05)。结论术前化疗对于心肌细胞有损伤,而对于术前化疗患者,七氟烷未加重心肌细胞损伤,可安全用于术前化疗患者麻醉。

Objective To evaluate the effect of sevoflurane on myocardial function in patients undergoing preoperative chemotherapy. Methods Thirty ASAⅠorⅡ patients underwent radical mastectomy under anesthesia with sevoflurane, among them 15 patients received preoperative chemotherapy （group S） and 15 patients did not receive preoperative chemotherapy （group C）. The blood samples were drawn before anesthesia （T0）, at the end of operation （T1）, 24h （T2） and 48h after operation （T3） to detecting the plasma concentrations of CK- MB, cTnI and NT- proBNP. Results There was no significant difference in plasma CK- MB levels between two groups （P〉0.05）;while plasma cTnI and NT- proBNP levels in group S were higher than those in group C （P〈0.05）. Compared to values of cTnI and NT- proBNP at T0, those values at T1, T2, T3 were not significantly changed in both groups （P〉0.05）. Conclusion Preoperative chemotherapy would induce myocardial injury, but sevoflurane does not ag-gravate the injury for patients undergoing preoperative chemotherapy.