异丙酚对颅脑手术创伤所致脑脊液兴奋性氨基酸和甘氨酸水平的影响

目的：观察异丙酚对颅脑手术创伤所致脊液兴奋性氨基酸（excitatory amino acids,EAA)(主要包括谷氨酸，天门冬氨酸）和甘氨酸（glycine,Gly)水平的影响。方法：选择会侵袭脑实质的颅内手术25例，分为异丙酚麻醉（n=13)和常规麻醉（n=12)两组，分别于术前，术中和术后检测脑脊液中EAA和Gly的浓度。结果：常规全身麻醉组术后脑脊液EAA和Gly含量显著升高，表明常规全身麻醉下颅脑手术后脑细胞外液EAA和Gly 的水平明显增加，提示手术刺激类似创伤，可引起脑细胞外液脑EAA和Gly聚集；异丙酚麻醉组手术后脑脊液EAA和Gly液水平明显低于非异丙酚麻醉组。结论：异丙酚可明显抑制颅脑手术所致脑细胞外液EAA和Gly的积聚。涉及颅脑实质的手术病例用异丙酚麻醉。对减轻颅脑术后继发性神经功能损伤的发生可能有一定的临床价值。

Effects of Propofol on Excitatory Amino Acids and Glycine Levels in Cerebrospinal Fluid after Brain Operation

OBJECTIVE: To observe the effect of propofol on the changes of excitatory amino acids(EAA)(including glutamate, aspartate) and glycine(GIy) metabolism induced by brain operation. METHODS: Patients who will be performed brain operation were entered into the study. Twenty five patients were randomized to either a propofol intravenous anesthesia (n=13) or a normally general anesthesia (n=12). Cerebrospinal fluid(CSF) samples were taken for examining EAA and Gly. RESULTS: The brain operation under normally general anesthesia induced an obvious increasing of EAA and Gly levels in CSF, but under propofol anesthesia the changes of EAA and Gly in CSF were more slightly. CONCLUTIONS: Propofol was able to inhibit definitely the enhance of EAA and Gly levels in the extracellular fluid of neurons induced by brain operation. The nature of propofol mentioned previously perhaps will play an important role to reduce the deuteropathic nervous dysfunction after brain operations.