摘要
目的 :利用静脉普鲁卡因复合麻醉 ( IPA)致体内氧自由基 ( OFR)含量增高的内环境变化 ,观察亚甲蓝 ( MB)在体内的抗氧化特性。方法 :40例择期手术患者 ,根据麻醉方法不同随机分为观察组 ( IPA,n=2 0 )和对照组 (芬太尼 ,n=2 0 )。分别观察麻醉诱导前 ( T0 )、麻醉 12 0 min( T1)、麻醉 180 min( T2 )以及静脉注射 MB( 1～ 2 mg/ kg)后 30 m in( T3)时患者血内一氧化氮 ( NO)、OFR、脂质过氧化物 ( L PO)、高铁血红蛋白 ( MHb)的含量以及红细胞 ( RBC)、超氧化物歧化酶 ( SOD)、过氧化氢酶 ( CAT)、还原型辅酶 细胞色素 b5还原酶( NADH cyt b5 R)活性的变化。结果 :IPA组 T1、T2与 T0相比 :NO、OFR、L PO、MHb均有显著性升高 ;SOD、CAT、NADH cyt b5 R均有显著性降低。经 MB治疗后 30 m in,NO等 7项指标均恢复至正常水平。芬太尼麻醉期间 ( T0～ T3)各指标无显著性变化。结论 :普鲁卡因在体内的代谢产物具有强氧化剂特性 ,通过产生过量的 NO:ONOO-介导 RBC过氧化损伤。临床治疗剂量的 MB在人体内具有直接清除 NO:ONOO-特性 ,对组织细胞可提供多途径的保护作用。
Objective:To investigate the relationship of oxygen free radical(OFR) with peroxidative injury of erythrocyte induced by intravenous procaine in vivo and the effect of methylene blue(MB) in removal of nitric oxide (NO) and peroxynitrite (ONOO-).Methods:Forty patients undergoing elective surgery were divided randomly into intravenous procaine anesthesia(IPA) group and fentanyl group.Blood sample was taken before anesthesia(T0),120 minutes(T1) and 180 minutes(T2) after IPA and 30 minutes after treatment with MB( 12 mg/kg,T3) to determine the changes in the levels of NO,OFR,lipid peroxide (LPO),superoxide dismutase (SOD),catalase (CAT),NADHCyt b5reductase (Cyt b5R) and methemoglobin (MHb). Results:Compared with T0,the levels of NO,OFR,LPO,MHb in IPA group were significantly increased at T1,T2.At same time SOD,CAT and Cyt b5R were significantly decreased.NO,OFR,MHb,SOD,CAT and Cyt b5R were all reduced to the normal levels at T3.No changes in any determined parameters in fentanyl group during anesthesia.Conclusion:It is indicated that the metabolites of procaine consist of a large quantity of NO:ONOO-,producing peroxidative injury to erythrocyte.MB is effective in eliminating OFR in vivo,protecting tissue cells.It may act as an antioxidant drug in the treatment of critical illness.
出处
《中国危重病急救医学》
CAS
CSCD
2003年第3期170-173,共4页
Chinese Critical Care Medicine
基金
海南省自然科学基金资助项目 ( 2 0 0 0- 80 0 10 )
