异丙酚对高血压脑出血患者脑组织保护作用研究

目的观察异丙酚对高血压脑出血患者血清白介素-1β(IL-1β)与肿瘤坏死因子-α(TNF-α)的影响以及其对脑组织的保护作用。方法临床纳入高血压脑出血患者90例,所有患者均接受颅骨钻孔引流术,根据患者术前麻醉方案的不同分为研究组与对照组。研究组给予异丙酚静脉持续滴注联合利多卡因局部浸润麻醉,对照组仅给予利多卡因局部浸润麻醉。分别于术前、术后24h、48h采集患者静脉血5mL,检测IL-1β、TNF-α水平。对比2组患者术后为缓解脑水肿使用的地塞米松、甘露醇、甘油果糖用量。结果研究组术后24h、术后48hIL-1β分别为(4.6±1.2)pg/mL、(5.4±1.0)pg/mL,对照组术后24h、48hIL-1β水平分别为(8.4±1.6)pg/mL、(9.2±1.6)pg/mL,差异均有统计学意义(P0.05);研究组术后24h、术后48hTNF-α分别为(43.1±12.3)pg/mL、(55.5±12.8)pg/mL,对照组术后24h、48hTNF-α水平分别为(74.8±13.9)pg/mL、(81.8±16.5)pg/mL,差异均有统计学意义(P0.05);研究组地塞米松、甘露醇、甘油果糖使用量分别为(28.8±3.9)mg、(188.1±12.4)g、(26.5±6.7)g,对照组地塞米松、甘露醇、甘油果糖使用量分别为(94.2±9.1)mg、(576.9±26.3)g、(109.6±12.3)g,差异均有统计学意义(P0.05)。结论异丙酚静脉输注能够有效降低术后患者地塞米松、甘露醇、甘油果糖的用量,改善患者术后颅内压过高,保护脑组织,其作用机制可能与下调血清IL-1β与TNF-α水平有关。

Protective effect research of propofol for brain tissues in patients with hypertensive cerebral hemorrhage

Objective To observe the influence of propofol for IL-1β and TNF-α in patients with hypertensive cerebral hemorrhage and its protective effect on the brain tissue. Methods Ninety patients with hypertensive cerebral hemorrhage re-ceived BHID and were divided into research group and control group according to the different preoperative anesthesia. The re-search group were treated with propofol (continuous infusion) combined with lidocainum (local infiltration anesthesia) while control group were treated with lidocainum (local infiltration anesthesia). Before surgery ,after 24 h and 48 h of surgery ,5 mL of venous blood was draw to detect the levels of IL-1βand TNF-α. For relief of brain swelling ,the dosage of DSMS ,mannitol and glycerin fructose of two groups were compared. Results The levels of IL-1β after 24 h and 48 h of surgery of research group were(4.6 ± 1.2)pg/mL and(5.4 ± 1.0)pg/mL and the levels of control group were(8.4 ± 1.6)pg/mL and(9.2 ± 1.6) pg/mL (P<0.05);the levels of TNF-αafter 24 h and 48 h of surgery of research group were(43.1 ± 12.3)pg/mL and(55.5 ± 12.8)pg/mL while the levels of control group were(74.8 ± 13.9)pg/mL and(81.8 ± 16.5)pg/mL ;the dosage of DSMS , mannitol and glycerin fructose of research group were(28.8 ± 3.9)mg ,(188.1 ± 12.4)g and(26.5 ± 6.7)g while the dosage of control group were(94.2 ± 9.1)mg ,(576.9 ± 26.3)g and(109.6 ± 12.3)g (P<0.05). Conclusion The intravenous infusion of propofol can effectively reduce the dosage of DSMS ,mannitol and glycerin fructose ,improve the higher intracranial pressure af-ter surgery and protect the brain tissue. Its mechanism may be correlated with the lower levels of IL-1βand TNF-α.