远端缺血预处理对动脉瘤栓塞术患者血浆S-100β、NSE及Ngb水平的影响

Effects of Remote Ischemic Preconditioning on Levels of Plasma S-100β, Neuron Specific Enolase and Neuroglobin in Patients with Cerebral Aneurysm Embolization

目的评价远端缺血预处理(RIPC)对动脉瘤行栓塞术患者血浆钙调蛋白(S-100β)、神经元特异性烯醇化酶(NSE)及脑红蛋白(Ngb)水平的影响。方法选取47例拟行栓塞术的动脉瘤患者,随机分为远端缺血预处理组(RIPC组):在手术开始前于左下肢实施RIPC干预;对照组:不进行缺血再灌注干预。分别在RIPC实施前、RIPC实施后和术后24 h采集患者血样本。采用ELISA法检测血浆S-100β、NSE和Ngb水平。结果 RIPC组的S-100β、NSE水平在组间同时间点和组内各时间点比较,无明显变化。RIPC组各时间点Ngb水平也未见明显差异;术后24 h,对照组Ngb水平与RIPC干预前比较显著下降(P<0.05);与RIPC组术后24 h时点比较,Ngb水平也显著下降(P<0.05)。结论 RIPC对动脉瘤栓塞患者血浆S-100β、NSE水平无影响,但在一定程度上维持了Ngb浓度。

Aim To evaluate the effect of remote ischemic preconditioning（RIPC） on plasma S-100β, Neuron specific enolase（NSE） and neuroglobin（Ngb） in patients with unrupture cerebral aneurysm undergoing embolization. Methods Forty-seven patients were randomly assigned into either remote ischemic preconditioning group（RIPC group, 25 cases） or the control group（22 cases）. In RIPC group, RIPC was performed in left limb after anesthesia induction before the embolization, which consisted of cuff inflation to 200 mm Hg for 3 × 5 min alternating with 5 min of intermittent reperfusion by complete cuff deflation. In the control group, the cuff was placed around the same limb, and no inflation and deflation were performed. The blood samples were collected before RIPC performed（T0）, after RIPC process（T1） and 24 h after the operation（T2）. All serum samples were detected by ELISA for S-100β, NSEand Ngb. Results No difference were found in the S-100β and NSE between the groups nor in the group. In the control group, the concentration of Ngb was significantly decreased compared with the baseline and RIPC group at 24 hour after the operation, meanwhile the Ngb in RIPC group didn＇t change significantly. Conclusion RIPC could inhibit the protective biomarker（Ngb） decline after the aneurysm embolization. Meanwhile, the process had no effect on the S-100β, NSE in serum.