咪达唑仑、丙泊酚、右美托咪定对食管癌根治术围术期氧化应激反应影响的比较

The effects of midazolam,propofol and dexmedetomidine on perioperative oxidative stress of patents with esophageal cancer

目的比较咪达唑仑、丙泊酚和右美托咪定对食管癌根治术患者围术期氧化应激反应的影响。方法择期行食管癌根治术患者45例,随机分为三组,分别采用咪达唑仑(M组)、丙泊酚(P组)或右美托咪定(D组)行麻醉诱导和维持。于手术前(T0)、手术开始2h(T1)、手术结束24h(T2)抽取静脉血,测定血清超氧阴离子(O-2)、羟自由基(OH)、过氧化氢(H2O2)、丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、过氧化氢酶(CAT)含量。结果与T0和T2时比较,T1时三组血清O-2、OH、H2O2、MDA含量明显增加,SOD、GSH-Px明显降低(P<0.05)。与M组比较,T1和T2时P组和D组O-2、OH、H2O2、MDA含量明显降低,SOD、GSH-Px明显增加(P<0.05)。结论右美托咪定和丙泊酚抗氧化能力强于咪达唑仑,而右美托咪定可能要强于丙泊酚。

Objective To compare the effects of midazolam, propofol and dexrnedetomidine on perioperative oxidative stress of patients with esophageal cancer. Methods Forty five patients with esophageal cancer were divided into 3 groups randomly： rnidazolam group （group M, n = 15）; propofol group （group P, n= 15） and dexmedetomidine group （group D, n = 15）. To take blood sample of all patients at the point of before the starting of operation （T0）, 2 h after the operation （T1） and 24 h after the operation （T2） to measure 02 , OH, H2O2, MDA, SOD and GSH-Px, monitoring life parameters of the perioperation. Results Compared to To and T2, the values of three groups patients of 02, OH, H202, MDA were significantly increased, but the values of SOD and GSH-Px were decreased （P^0.05）. Compared to group M, the concentration of 02, OH, HzO2, MDA of group P and group D were significantly decreased at T1 and T2, but the value of SOD and GSH-Px was significantly decreased （P ~ 0.05 ）. Conclusion The anti-oxidative stress of dexmedetomidine and propofol were more powerful than midazolam; Furthermore, the time of antb ox/dative stress of dexmedetomidine was longer than propofoL