异丙酚对急性颅脑损伤患者血内一氧化氮及相关因子含量的影响

Effects of propofol on the level of nitric oxide and related factors in patients with acute cerebral injury

目的 观察异丙酚 (PRO)对急性颅脑损伤 (ACI)患者围术期血内一氧化氮 (NO)产量、一氧化氮合成酶 (NOS)、红细胞超氧化物歧化酶 (SOD)活性、氧自由基 (OFR)含量的影响。方法 4 0例ACI患者随机分为PRO组和γ -OH组。观察自麻醉诱导前至开颅手术去骨瓣后 1,3 ,6,12 ,2 4h (T0 ～T5)诸指标水平变化。并以 4 0例健康者作术前对照。结果 与正常对照组相比 ,两组术前NOS、OFR均显著增高 (P <0 0 5 ,P <0 0 1) ,SOD显著降低 (P <0 0 1)。与γ OH组相比 ,PRO组NO、NOS自始至终呈降低趋势 ,NOS于T1、SOD于T2 、NO及OFR于T3时达到正常水平 (与T0 相比均P <0 0 1)。结论 临床麻醉剂量的PRO具有非选择性NOS抑制剂、OFR清除剂特性 ,对ACI患者有多位点的脑保护作用。

Objective To investigate the effects of propofol(PRO)on the plasma level of nitric oxide(NO) production,nitric oxide synthase activity(NOS) and erythrocyte superoxide dismutase(SOD) activity,oxygen free radical(OFR) level in perioperative patients with acute cerebral injury(ACI) requiring neurosurgery.Methods Forty patients with ACI were divided randomly into two groups,propofol anesthesia and γ-OH control.Blood samples were drawn before anesthesia to 1,3,6,12,24 hours(T 0 T 5) of anesthesia.Results NOS activity and OFR levels were significantly increased( P <0 05 and P <0 01)respectively,SOD activity was significantly decreased( P <0 01) before operation in patients with ACI compared to normal value.In γ-OH group the levels of NO(T 1,T 5),NOS(T 5)and OFR were significantly increased (all P <0 01) and SOD was significantly decreased( P <0 01) compared to T 0.In propofol group NOS activity(T 2 T 5),NO(T 3 T 5) and OFR(T 3) were significantly decreased compared to T 0.Meanwhile SOD(T 2) was significantly increased compared to T 0(all P <0 01).Conclusion Therapeutic dose of propofol may significantly inhibit NOS activity and acts as an OFR scavenger.Hence,propofol has many cerebral protective effects in patients with ICA. Key words Nitric oxide;Nitric oxide synthase;Oxygen free radical; Cerebral injury;Propofol