异丙酚与安氟醚或七氟醚静吸复合麻醉对氧自由基的影响

Effect of propofol-enflurane and propofol-sevoflurane combined anaesthesia on oxygen-derived free radicals

目的 :观察异丙酚与安氟醚、七氟醚静吸复合麻醉对氧自由基的影响。方法 :32例择期手术的全麻病人 ,随机分为 4组 (每组 8例 ) ,分别给予安氟醚麻醉 ( A组 )、七氟醚麻醉 ( B组 )、异丙酚-安氟醚麻醉 ( C组 )、异丙酚 -七氟醚麻醉 ( D组 )。其中 A、B组为对照组 ,C、D组为观察组。分别于麻醉前及麻醉诱导后 1 5 min、1 h和 2 h采集静脉血测红细胞超氧化物岐化酶 ( SOD)、血清丙二醛( MDA)。结果 :麻醉后 ,A、B两组 SOD值均逐渐下降 ,MDA值均逐渐升高 ,麻醉诱导后 2 h SOD、MDA值较麻醉前差异均有显著性 ( P<0 .0 5 ) ,但 A、B两组相比较 ,SOD、MDA值差异均无显著性( P>0 .0 5 ) ;C、D两组 SOD值较麻醉前均有下降趋势 ,但差异均无显著性 ( P>0 .0 5 ) ,MDA值较麻醉前均逐渐下降 ,并于麻醉诱导后 2 h差异均有显著性 ( P<0 .0 5 ) ,但 C、D两组相比较 SOD、MDA值差异均无显著性 ( P>0 .0 5 )。A与 C组之间相比较及 B与 D组之间相比较 ,SOD值在麻醉诱导后 2 h差异均有显著性 ( P<0 .0 5 ) ;MDA值在麻醉诱导后 1 h及 2 h差异均有显著性( P<0 .0 5、P<0 .0 1 )。结论 :安氟醚和七氟醚均能产生自由基使 MAD升高、SOD下降 ;临床麻醉剂量的异丙酚能有效地清除自由基、降低 MDA。

Objective:To investigate the effect of propofol enflurane and propofol sevoflurane combined anaesthesia on oxygen derived free radicals. Methods:Thirty two adult patients scheduled for selective surgery under general anaesthesia were randomly allocated to Group A receiving enflurane, Group B receiving sevoflurane, Group C receiving propofol enflurane and Group D receiving propofol sevoflurane to maintain anaesthesia. Group A and group B were set up as control groups. The blood specimens were taken from all patients before anaesthesia and 15 min, 1 h and 2 h after induction to measure the serum concentration of SOD and MDA. Results: After anaesthesia, in Group A and group B the concentration of SOD decreased gradually and the concentration of MDA increased gradually .These changes were statistically significant ( P <0.05) 2h after induction . There was no significant differences between Group A and group B in the concentration of SOD and MDA ( P >0.05). There was also trends of SOD decrease without statistic significance ( P >0.05) in group C and group D. As MDA level decreased significantly 2 h after induction ( P <0.05) in these two groups there was no significant differences between the both groups. In comperision of Group A with group C and group B with group D the concentration of SOD decreased significantly 2 h after induction ( P <0.05) and the concentration of MAD increased significantly 1 h and 2 h after induction. ( P<0.05,P <0.01). Conclusion: Enflurane and sevoflurane also can produce oxygen derived free radicals to decrease SOD and to increase MAD; Propofol in clinical dose can eliminate oxygen derived free radicals effectively and decrease the concentration of MDA.