摘要
目的探讨异丙酚或七氟烷对心肌缺血患者麻醉前后血清肌钙蛋白T(cTnT)和血清同型半胱氨酸(HCY)浓度的影响。方法选择48例缺血性心脏病史择期手术的患者,随机分成异丙酚组(A组)和七氟烷组(B组),每组24例,于麻醉前、术毕及术后6h、24h、48h分别采静脉血检测血清cTnT和HCY浓度。结果两组患者血清cTnT浓度在术后及术后6h有所上升,但与麻醉前水平相比差异无统计学意义(P>0.05);其中A组在术后24h浓度开始回落,至术后48h浓度显著低于麻醉前水平(P<0.05),B组在术24h浓度均有所下降,但与麻醉前比较差异无统计学意义(P>0.05)。两组患者血清HCY浓度在术毕上升,与麻醉前比较差异无统计学意义(P>0.05);其中A组术后6h浓度开始回落,至术后48h浓度较麻醉前显著降低,B组在术毕浓度升高,并在术后6h至48h维持较高水平。结论异丙酚能降低心肌缺血手术患者血清cTnT和HCY水平,减轻心肌损伤的作用较七氟烷明显,且对心血管具有保护作用。
Objective To investigate the effect of propofol or sevoflurane anesthesia on cardiac troponin T（cTnT）and serum homocysteine（HCY）in patients with myocardial ischemia,for guiding clinical reasonable choice of narcotic drugs.Methods 48 cases of patients with myocardial ischemia were randomly and averagely divided into propofol group（A）and sevoflurane group（B）,and blood serum was collected at various time-points：pre-anesthesia,surgery,6hours after surgery,24 hours after surgery and 48 hours after surgery.Results cTnT concentration increased after surgery and 6hours after surgery in two groups,but no significant difference were observed when compared with the level before anesthesia.cTnT concentration in group A decreased at 24 hours and cTnT level at48 hours were significantly lower than the level before anesthesia（P〈0.05）.Meanwhile,the level of cTnT in group B slightly decreased at 24 hours after surgery including 48 hours,but there were no statistical significantly differences with level of before anesthesia（P〉0.05）.HCY increased after surgery,but there was no significant difference between two groups（P〉0.05）.HCY in group A decreased after 6hours,and the level at 48 hours was significantly lower than pre-surgery.HCY were at high level at end of operation and surgery after 6-48 hours in group B.Conclusion Propofol is more effective than sevoflurane in reducing serum cTnT,the serum HCY levels and protecting cardiovascular for patients with myocardial ischemia.
出处
《贵州医药》
CAS
2016年第2期143-145,共3页
Guizhou Medical Journal
