比较异丙酚和依托咪酯对心脏瓣膜置换术患者过氧化脂质和超氧化物歧化酶的影响

目的:观察异丙酚对心脏瓣膜置换术患者过氧化脂质和超氧化物歧化酶的影响。方法:20例瓣膜置换术患者分为异丙酚组和依托咪酯组。分别在心肌缺血再灌注前后取血做过氧化脂质和超氧化物歧化酶测定,同时记录心电图和平均动脉压。结果:过氧化脂质在异丙酚组主动脉插管时下降,主动脉开放后升高,均有显著差异(P<0.05,P<0.01)。依托咪酯组主动脉开放后明显升高,亦高于异丙酚组同时值,差异均显著(P<0.01)。超氧化物歧化酶主动脉开放后两组均下降(P<0.05,P<0.01),两组间无差异。主动脉开放后心律失常、心肌缺血、电击复跳例数异丙酚组少于依托咪酯组。结论:异丙酚可明显降低心肌缺血再灌注后过氧化脂质含量,减少心律失常和心肌缺血现象。

Effects of propofol and etomidate on lipid peroxides and superoxide diomutase in patients undergoing caroiac valve replacemant

Objective: To observe the effects of propofol on lipid peroxides(LPO)and superoxide diomutase(SOD) during open heart surgery. Method: Twenty patients undergoing cardiac valve replacement, were diviced into two groups: propofol group and etomidate group. The serum samples were taken to measure LPO and SOD lerels before and after ischemic reperfusion,and recorded ECG and MAP. Result: The serum LPO level decreased sign ficantly during aortic cannulation,and increased after aortic cross-release in propofol group(P<0.05, P<0.01). In etomidate group the LPO level increased markedly after aortic cross-release,and were higher at corresponding times than those in propofol group(P<0.01). The SOD level decreased significantly after aortic cross release in all patients, but there was no difference between two groups. The rate of patients with arrhythmia,ischemic myocardial in propofol group was lower than that in etomidate group. Conclusion: Propofol can reduce the serum levels of LPO,SOD after reperfusion. and reduce arrhythmia and ischemic myoacrdial occurring.