乌司他丁对幕上肿瘤切除术患者颈内静脉球部血清SOD和MDA含量的影响

目的 观测乌司他丁对幕上肿瘤切除术患者颈内静脉球部血清超氧化物歧化酶（SOD）、丙二醛（MDA）含量的影响。方法 择期行幕上肿瘤切除术患者24例,年龄18~55岁,ASAⅠ~Ⅱ级。随机数字表法分为对照组（A组,12例）、乌司他丁组（U组,12例）,U组在切皮时予2 kU/kg乌司他丁静脉推注,随后予1 kU·kg^-1·h^-1泵注至术毕。A组于相同一时点输入等量0.9%生理盐水。分别全麻诱导前（T₁）、切皮前（T₂）、切硬脑膜后1 h（T₃）、缝硬脑膜时（T₄）手术结束（T₅）、术后24 h（T₆）6个时点同步采集颈内静脉球部血,采用改良盐酸羟胺法和TAB荧光法测定SOD、MDA含量。结果 SOD活性T₃~T₆均较T₁显著下降（P<0.001）,MDA含量T₃~T₆均较T₁显著上升（P<0.001）,SOD活性U组T₃~T₆高于A组（P<0.001）,MDA含量U组T₃~T₆较 A组显著降低（P<0.001）。结论 乌司他丁能提高患者术中、术后24 h内血清SOD活性,降低MDA含量,抗脂质过氧化反应是其发挥脑保护作用的机制之一。

The effect of Ulinastatin on the concentration of SOD and MDA in patients undergoing supratentorial tumor resection

Objective To observe the concentration of superoxide dismutase （SOD）, malondialdehyde （MDA） in patients undergoing supratentorial tumor resection with Ulinastatin treatment. Methods 24 patients with supratentorial tumor resection,aged between 18 and 55 yeas old, ASAⅠorⅡ, were randomly divided into the control group （group A, n=12） and Ulinastatin groups （group U, n=12）. Patients in Group U received Ulinastatin （2 kU/kg） at the beginning of the surgery, with the continuous dose of 1 kU·kg^-1·h^-1 till the end of the operation. Group A received equivalent volume of saline solution as the vehilcle control. Blood samples were taken from the artery and jugular venous bulb before induction of anesthesia （T₁）, skin incision （T₂）,1 h after dura openning （T₃）, at the closure of dura （T₄）, at the end of operation （T₅）and 24 h after operation （T₆） to analysis the concentration of superoxide dismutase （SOD） andmalondialdehyde （MDA）. The concentration of superoxide dismutase （SOD）, malondialdehyde （MDA） were determined by improved hydroxylamine hydrochloride method and TAB fluorescence method. Results The concentration of serum MDA were more dramatic rise at T₃-T₆ than at T₁ in both groups. The concentration of serum SOD were more dramatic decline at T₃-T₆ than at T₁ in both groups. The concentration of SOD and MDA increasd and decreased significantly at T₃-T₆ in group U than that in group A （P<0.001）. Conclusion Ulinastatin can improve the concentration of serum SOD and decrease MDA during surgery, which indicates the alleviating for the brain injury during supratentorial tumor resection.