地塞米松对体外循环心瓣膜置换术患者血S-100β和神经元特异性烯醇化酶的影响

中国临床药理学与治疗学 ›› 2007, Vol. 12 ›› Issue (12): 1424-1427.

地塞米松对体外循环心瓣膜置换术患者血S-100β和神经元特异性烯醇化酶的影响

采海虹¹, 王±雷², 王世端², 江岩², 袁莉², 刘英志²

¹青岛大学医学院, ²青岛大学医学院附属医院麻醉科,青岛 266001,山东

收稿日期:2007-08-11 修回日期:2007-10-07 发布日期:2020-11-10
通讯作者: 王±雷,男,博士,硕士研究生导师,研究方向:脏器功能保护。Tel:13792831632 E-mail:wshlei@yahoo.com.cn
作者简介:栾海虹,女,硕士研究生,研究方向:脏器功能保护。Tel:13969778543 E-mail:Ihh2005qd@126.com
基金资助:
山东省科技攻关计划赞助(2006GG3202004)

Effects of dexamethasone on blood S100β and Neuron Specific Enolaselevels in cardiac valve replacement patients undergoing cardiopulmonarybypass

LUAN Hai-hong¹, WANG Shi-lei², WANG Shi-duan², JIANG Yan², YUAN Li², LIU Ying-zhi²

¹Medical College of Qingdao University, ²Affliaied Hospital of Qingdao Medical College, Qingdao 266001 Shandong, China

Received:2007-08-11 Revised:2007-10-07 Published:2020-11-10

摘要/Abstract

摘要： 目的: 探讨地塞未松对体外循环下心脏瓣膜置换术患者血S-100β和神经元特异性烯醇化酶(NSE)的影响及其机制。方法: 择期体外循环下心脏瓣膜置换术病人30例,年龄31~63岁,体重46~76kg,ASAⅡ或Ⅲ级,随机分为地塞米松组和对照组。地塞米松组于手术开始前1h静注地塞米松0.5 mg/kg,对照组静注等量生理盐水。在静注地塞米松前(T₁)、体外循环开始(转机)即刻(T₂)、体外循环结束时(T₃)、手术结束时(T₄)、术后24 h(T₅)、术后48h(T₆)采集静脉血(T₁取自外周静脉,T₂~T₆取自颈内静脉置管),采用ELISA法测定TNF-α、IL-1β及脑损伤标志物S-100β蛋白和NSE的浓度。结果: 两组病人IL-1β、TNF-α浓度在T₂~ T₅均高于T₁(P < 0.05),且地塞米松组低于对照组(P < 0.05),T₆恢复至T₁水平。两组病人NSE浓度在T₃~ T₆ 时明显高于T₁~ T₂(P < 0.05),且T₃~T₅时地塞米松低于对照组(P < 0.05)。两组病人S-100β蛋白浓度在T₃~ T₅时高于T₁~ T₂(P < 0.05),T₆时基本恢复至T₁水平,且在T₃~T₄时地塞米松低于对照组(P < 0.05)。结论: 地塞米松能降低心脏瓣膜置换术病人血S-100β和NSE的水平,其脑保护机制与减少促炎细胞因子释放有关。

关键词: 地塞米松, 体外循环, 全身炎症反应综合征, 脑保护, 炎性因子

Abstract: AIM: To observe the effects of dexam-ethasone (DXM) on blood S100Β and Neuron SpecifieEnolase NSE) levels of cardiac valve replacement pa-tients undergoing cardioqulnonary bypass (CPB). METHODS: 30 patients, who were 31-63 years old,weighted 46-76 kg, ASAIl-Ill, were randonized toreceived 0.5 mg/kg dexanethasone (dexanethasonegnoup) or plceho(control group) 60 minutes before oper-alion. The plasma levels of TNF-α, IL-Iβ, S-1003 ard NSE were measured at the follwing times: before thedexamethasone or lacehe were aiminisered(T₁) before-stating CPB(T₂), the end of CPB(T₃), imnediately af-ter oeration T₄).24 h aler skin doue(T₅) and 48hafter skin closure(T₆). RESULTS: Both the plasrna com-centrations of TNF-α, IL-Iβ were upregulated after T₂.S-100 β, and NSE were upregulated after T₃(P < 0.05)and alnoestly resume to nomal level at T₆. The plasma cocentratins of TNF-α, IL-Iβ, S100βand NSE in dex-amethasone group were lower than those in placebo grup(P < 0,05). CONCLUSION Dexamethasone may de-crease the blood S-100Β and NSE levels after cardiopul-monary bypass by iting the release of prinfianmnatory cytokine.

Key words: dexamethasone, cardioqulmonary by-pas, systemic inflammalory response syndromns, inflam-matory cytokine, erebral protection

中图分类号:

R969

采海虹, 王±雷, 王世端, 江岩, 袁莉, 刘英志. 地塞米松对体外循环心瓣膜置换术患者血S-100β和神经元特异性烯醇化酶的影响[J]. 中国临床药理学与治疗学, 2007, 12(12): 1424-1427.

LUAN Hai-hong, WANG Shi-lei, WANG Shi-duan, JIANG Yan, YUAN Li, LIU Ying-zhi. Effects of dexamethasone on blood S100β and Neuron Specific Enolaselevels in cardiac valve replacement patients undergoing cardiopulmonarybypass[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2007, 12(12): 1424-1427.

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