摘要
目的评价乌司他丁对体外循环（CPB）下主动脉弓手术患儿脑损伤的影响。方法拟在CPB下行主动脉缩窄或主动脉弓离断合并心内畸形矫治术的患儿20例，性别不限，年龄1～24月，体重3～12kg，ASA分级Ⅲ或Ⅳ级。采用随机数字表法，将其分为2组（n=10）：对照组（C组）和乌司他丁组（U组）。u组将乌司他丁2万U／kg用生理盐水稀释至1万U／ml，麻醉诱导后颈内静脉注射1／3量，CPB开始和主动脉开放前约5min各使用1／3量；C组以等容积生理盐水替代。分别于麻醉诱导后（T1）、主动脉阻断10min（T2）、主动脉开放10min（T3）、CPB结束（T4）、CPB结束后6h（B）和CPB结束后24h（L）时采集桡动脉血，采用ELISA法测定血浆S100B蛋白和神经元特异性烯醇化酶（NSE）浓度。结果两组T1时血浆S100B蛋白及NSE浓度差异无统计学意义（P〉0．05）；与E时比较，两组T2-5时血浆S100B蛋白及NSE浓度升高（P〈0．05）；与C组比较，U组T2-5时血浆S100B蛋白及NSE浓度降低（P〈0．05）。结论乌司他丁可减轻CPB下主动脉弓手术患儿的脑损伤。
Objective To evaluate the effects of unilastatin on brain injury in children undergoing aortic arch surgery under cardiopulmonary bypass （CPB） .Methods Twenty ASA pbysical status Ⅲ or Ⅳ children of both sexes, aged 1-24 months, weighing 3-12 kg, undergoing repair of eoarctation of aorta or interrupted aortic arch complicated with intracardiac malformations under CPB, were randomly divided into 2 groups （ n = 10 each） ： control group （group C） and ulinastatin group （group U） . Ulinastatin 20 000 U/kg was diluted into 10 000 U/ml with normal saline and it was then injected intravenously in 3 parts （1/3 was injected via the internal jugular vein after induction of anesthesia; 1/3 at the beginning of CPB and 1/3 at 5 min before aortic unclamping）. In group C the equal volume of normal saline was given instead of ulinastatin. Blood samples were taken from the radial artery after induction of anesthesia （TI ）, at 10 min after aortic clamping （T2）, at 10 min after aortic unclamping （T3）, at the end of CPB （T4）, and at 6 and 24 h after termination of CPB （T5, T6 ） for determination of plasma SI00B protein and neuron-specific enolase （NSE） concentrations. Results There was no significant difference in plasma levels of SIOOB protein and NSE at T1 between the two groups （ P 〉 0.05）. Plasma S100B protein and NSE levels were significantly increased at T2_5 as compared to the baseline values at T1 in both groups （ P 〈 0.05）. Plasma S100B protein and NSE levels were significantly lower at T2-5 in group U than in group C （ P 〈 0.05） . Conclusion Ulinastatin can attenuate brain injury in children undergoing aortic arch surgery under CPB.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2013年第5期579-582,共4页
Chinese Journal of Anesthesiology
基金
天普研究基会2010年立项项目（01201043）
重庆市卫生局医学科研课题资助项目（2012-2-094）
