丙泊酚或七氟烷对体外循环术患者炎症反应的影响

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1、摘要0．461士0．102；S组T1,---,T5TLR4表达水平分别为0．305士0．071，0．220士0．056，0．224土0．055，O．312士0．057和0．403士0．065。结论：体外循环病人术后可出现全身性炎症反应，TLR4表达水平变化在其发生发展中有一定作用，七氟烷对体外循环病人术后炎症反应有抑制作用，其效果优于丙泊酚。【关键词】丙泊酚；七氟烷；TLR4；体外循环；炎症反应Abs订actABSTRACTObjective：inflammationistheseriouscomplicationsduringcardiopu

2、lmonarybypass(CPB)．Anesthesiologistsalwayswanttomitigateinflammationduringcardiopulmonarybypass(CPB)byanestheticinterventionandmeans．Inthisstudy,inordertoprovideareferenceofthechoiceofnarcoticdrugsduringCPB，propofolwascomparedtosevofluraneabouttheeffectoninflammationduringCP

3、B．InordertoprobetheeffectofTLR4oninflammationduringCPB，andtoprovideatheoreticalbasisofmeansofpreventionandcureforinflammationduringCPB，thechangeoftheexpressionofTolllikereceptorfour(TLR4)inperipheralmononuclearcellWasanalyzed．Methods：Fortypatients，eighteentoforty-fiveyearsol

4、d，andASAII—III，withheartvalvediseasesunderwentCPB，weredividedintotwogroups：groupP(propofolgroup，n=20)andgroupS(sevofluranegroup，n220)．Itwasexcludedpatientswithliverandkidneydysfunction，andwhohasusedglucocorticoidornon—steroidalanti—inflammatorydrugsintwoweeks．Inbothtwogroups

5、，anesthesiawasinducedwitllintravenousinjectionofmidazolam(0．05N0．15mg／kg)，fentanyl(5ug'--'30ug／kg)，propofol(1～2．5mg／kg)，andvecuronium(0．08"～0．12mg／kg)，andmaintainedwithintermittentintravenousinjectionofmidazolam，fentanylandvecuronium．Propofol(2．5～'5mg／kg·h)waspumpedingroupPa

6、ndsevoflurane(1"～2MAC)wasinhaledingroupSformaintenanceofanesthesia．BispectralIndex(BIS)Wasfluctuatedfromfo啊tosixty．Thechangesofbodytemperature，respiratoryfrequencyandheartratewereobservedatfivedifferenttimepoints⋯preanesthesia，pre-CPB，0hours，4hoursand24hourspostCPB．Ateachtim

7、eperipheralvenousbloodwassampled．Thewhitebloodcellcount，neutrophilcount，theconcentrationofIL一6andTNF，theexpressionlevelofTLR4weredetectedatthesefivedifferenttimepoints．BoththeconcentrationofIL．6andTNFweremeasuredbyradioimmunoassay；andtheexpressionlevelofTLR4wasmeasuredbyRT-P

8、CR．VAbstract量tesuits：1．Therewasnosignificantdifferenceinpatients’gendeLage，