依达拉奉对二尖瓣置换术患者的脑保护作用

目的：观察依达拉奉对体外循环（CPB）下行二尖瓣置换术患者的脑保护作用，并探讨其机制。方法选择选择2010年1月-2013年8月于首都医科大学石景山教学医院拟行二尖瓣置换手术患者36例，随机分为依达拉奉组和对照组，每组各18例。依达拉奉组将依达拉奉30 mg加入100 mL生理盐水中于体外循环前30 min静脉滴注；对照组输入等量生理盐水。分别于麻醉后用药前（T1）、CPB结束后5 min（T2）、4 h（T3）、24 h（T4）、48 h（T5）、72 h（T6）检测血清中的神经元特异性烯醇化酶（NSE）、神经组织蛋白（S-100ββ）水平。观察并比较两组术后神经系统并发症的发生情况。结果 T1时点两组NSE水平比较，差异无统计学意义（P〉0.05）。依达拉奉组NSE水平在T2时点低于对照组，差异有统计学意义（P〈0.05），在T5时点则基本降至正常范围。与T1时点比较，依达拉奉组S-100ββ水平在T2和T3时点显著升高，差异有高度统计学意义（〈0.01），在T4时点基本降至正常范围。两组血清S-100ββ蛋白峰值均出现在T2时点。T1时点两组S-100ββ水平比较，差异无统计学意义（P〉0.05）；T2、T3、T4时点依达拉奉组S-100ββ水平均低于对照组，差异有统计学意义（P〈0.05）。两组术后神经系统并发症情况比较差异无统计学意义（P〉0.05）。结论依达拉奉可减少神经组织蛋白、神经元特异性烯醇化酶在围体外循环期的表达，对心脏瓣膜手术患者有一定脑保护作用。

Cerebral protective effect of Edaravone in patients underwent mitral valve replacement

Objective To observe the cerebral protective effect of Edaravone in patients underwent mitral valve re-placement, and discuss its mechanism. Methods 36 cases of patients underwent mitral valve replacement were select-ed, and randomly divided into the Edaravone group and the control group, with 18 cases in each group. Patients in the Edaravone group were given 30 mg Edaravone added 100 mL saline for intravenous drip 30 min before cardiopul-monary bypass, while patients in the control group were given the same amount of saline. The NSE and S-100ββ lev-els were detected before drug given （T1）, 5 min （T2）, 4 h （T3）, 24 h （T4）, 48 h （T5）, 72 h （T6） after cardiopulmonary by-pass. The neurological complications were recorded and compared. Results At T1, there was no significant difference in NSE level between the two groups （P〉0.05）. At T2, the NSE level in the Edaravone group was lower than that in the control group, the difference was statistically significant （P〈0.05）, and it basically dropped to normal at T5. Compared with T1, S-100ββlevel in the Edaravone group increased at T2 and T3, the differences were statistically significant （P〈0.01）, and it basically dropped to normal at T4. In the two groups the peak value of S-100ββall appeared at T2. At T1, there was no significant difference in S-100ββ level between the two groups （P〉 0.05）. At T2, T3, T4, the S-100 ββlevels in the Edaravone group were lower than the control group, the differences were statistically significant （P〈0.05）. The neurological complications had no significant difference between the two groups （P〉0.05）. Conclusion Edaravone can reduce the expression of NSE and S-100 ββ before cardiopulmonary bypass, which has cerebral protective effect for patients with cardiac valvular surgery.