比较丙泊酚和依托咪酯对体外循环围术期氧化应激的影响

Comparison of Propofol and Etomidate on the Influence of Extracorporeal Circulation Perioperative Oxidative Stress

目的观察丙泊酚、依托咪酯对体外循环心脏瓣膜置换手术患者围术期氧化应激反应的影响。方法择期拟行体外循环心脏瓣膜置换手术患者40例,随机分为2组(每组20例):丙泊酚组(P组)和依托咪酯组(E组)。分别于入室后(T0)、切皮时(T1)、体外循环开始前(T2)、手术结束时(T3)、术后6 h(T4)、24 h(T5)、48 h(T6)、72 h(T7)记录患者心率(HR)和平均动脉压(MAP),并于T0、T4、T5、T6、T7取血测定过氧化物歧化酶(SOD)、过氧化氢酶(CAT)和谷胱甘肽过氧化物酶(GSH-Px)含量。结果 2组患者在T5和T6时点SOD、CAT和GSH-Px活性均低于术前(P<0.05)。E组SOD活性在T4至T7均明显低于P组(P<0.05),E组CAT活性在T5和T6明显低于P组(P<0.05),E组GSH-Px活性在T4至T6均明显低于P组(P<0.05)。与P组相比,E组术后ICU停留时间明显增加(P<0.05)。结论与依托咪酯相比较,丙泊酚能更好地降低体外外循环瓣膜置换术围术期的氧化应激反应。

Objective Observation of propofol and etomidate in extracorporeal circulation heart valve replacement surgery patients perioperative effects of oxidative stress reaction. Methods Names of quasi line 40 patients with extracorporeal circulation heart valve replacement surgery, Randomly divided into 2 groups （20 cases in each group） ：Propofol group （P group） and the etomidate group （group E）.In the house after （T0）,When cutting leather （T1）, before the start of extracorporeal circulation （T2）, （T3） at the end of surgery, postoperative 6 h （T4） （T5）, 24 h, 48 h （T6）, 72 h （T7 has） record patients＇ heart rate （HR） and mean arterial pressure （MAP）,And TO, T4, T5, T6, T7 has draw blood to determine superoxide dismutase （SOD）, catalase （CAT） and glutathione peroxidase （gsh-px） content. Results 2 groups of patients in T5 and T6 point SOD, CAT and gsh-px activity were lower than the preoperative （P 〈 0.05）. Group E SOD activity in T4 to T7 has group were significantly lower than that ofP （P 〈 0.05）, CAT activity in T5 and T6 group E was lower than that in group P （P 〈 0.05）, gsh-px activity between T4 and T6 group E were significantly lower than that of P group （P 〈 0.05）.Compared with P group, group E postoperative ICU stay time increased significantly （P 〈 0.05）. Conelnsion Compared with etomidate, propofol can better reduce the external loop valve replacement in vitro periopemtive oxidative stress reaction.