单侧肺通气对不同年龄胸外科手术患者氧化应激的影响

Effects of Different Age on Level of Oxidative Stress for Thoracic Surgery Patients with One Lung Ventilation

目的:探讨单侧肺通气对不同年龄组开胸手术患者氧化应激水平的影响。方法:将开胸手术单侧肺通气96例患者按年龄分成青年组(23-5岁),壮年组(46-64岁),老年组(65-85岁)各32例,均行双腔气管插管单侧肺通气并全麻下行开胸手术,分别于术前当天(8:00am)(T_0)、手术开始后90 min(T_1),术毕60 min(T_2),术后第1 d(8:00am)(T_3),术后第2 d(8:00am)(T_4)五个时间点采集中心静脉血,采用化学比色法测定并比较血清丙二醛(MDA),一氧化氮(NO),超氧化物歧化酶(SOD),谷胱甘肽过氧化物酶(GSH-PX)的水平。结果:三组患者的MDA、NO水平在T_1-T_4时点均较T_0明显升高,P<0.05,T_1-T_3渐次升高,两两比较P均<0.05,T_4较T_3有所下降,但无显著性差异,P>0.05;而SOD、GSH-PX水平则有所下降,其中T_1-T_3均较T_0明显降低,P<0.05,T_4与T_3比较无明显差异,P>0.05。三组患者的组间比较:老年组各个时间点的MDA、NO值均显著高于青年组和壮年组,P<0.05;壮年组较青年组有升高,但差异无显著性,P>0.05;老年组各个时间点SOD、GSH-PX的测定值均低于青年组和壮年组,P<0.05,青年组和壮年组比较无明显差异,P>0.05。结论:单侧肺通气开胸手术可致患者氧化应激反应加重,其中对老年人的影响尤为严重。

Objective ：To explore the effect of different age on level of oxidative stress for thoracic surgery patients with on lung ventilation. Methods ：96 cases undergoing thoracic surgery were divided into three groups according the age ：youth group（23-45y）, middle aged group（46-64y） and older age-group（65-85y）, each group was 32 case. Blood samples were taken from central venous at Eight am. on the day of surgery（baseline T_0）, 90 minutes after the operation（T_1）, 60 minutes end of operation（T_2）, first postoperative day（T_3） and postoperative day two（T_4）.The levels of MDA,NO,SOD and GSH-PX in serum were measured with colorimetry and compared. Results ：The level or activity of MDA and NO in serum in each group were significantly increased at T_1-T_4 than those at T_0（P〈0.05）, and all blood samples in older age-group were higher than other two groups. On the other hand,the level of SOD 、GSH-PX were significantly decreased when T_1-T_4 compare with T_0（P〈0.05）,and there was no significant difference among T_3, T_4（P〉0.05）. Conclusion ：The oxidative stress in thoracic surgery patients with one lung ventilation were increased,especially in the elderly group.