氯胺酮对体外循环心脏病患儿血浆NSE和S100β蛋白的影响(1)
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[摘要] 目的 研究氯胺酮(Ketamine)在婴幼儿体外循环手术患者血浆神经元特异性烯醇化酶(NSE)和S100β蛋白的影响。方法 选择28例拟在CPB下行室间隔缺损的婴幼儿患者，随机分为两组各14例。氯胺酮组(K组)转流前经中心静脉泵入氯胺酮1mg/kg；对照组(C组)给予等量平衡液。分别于转流前和转流完毕时从中心静脉采血，使用ELISA法测定血浆NSE和S100β蛋白的浓度。结果 ①与转流前相比，转流后C组NSE和S100β含量均明显升高 (P <0.05)；②组间比较，转流前两组的NSE和S100β含量变化不明显，转流后C组NSE和S100β含量明显高于K组 ( P <0.05)。 结论 氯胺酮的应用可减少婴幼儿CPB术后血浆NSE和S100β蛋白的释放，从而对脑损伤起到保护作用。
[关键词] 氯胺酮；体外循环；NSE；S100β
[中图分类号] R654.1 [文献标识码] A [文章编号]1673-9701(2011)22-51-02
Effects of Ketamine on Concentration of NSE and S100β in Plasma after Cardiopulmonary Bypass in Infants with Heart Disease
WANG Penggao CHEN Zhongjian DONG Xiangyang HE Dongyang LI Jiwei ZHAI Bo
Department of Thoracic and Cardiovascular Surgery，Zhengzhou Municipal Children’s Hospital，Zhengzhou 450053， China
[Abstract] Objective To investigate the effects of ketamine on plasma NSE and S100β in plasma after cardiopulmonary bypass (CPB) in infants. Methods Twenty-eight patients for repair of ventricular septal defect (VSD) were randomly divided into two groups： ketamine group (group K， n=14) received ketamine 1mg/kg intravenously before CPB and control group (group C，n=14) received normal saline instead of Ketamine. Blood samples from external cycle were collected before start of CPB and after termination of CPB for determination of plasma NSE and S100β concentration， respectively. Results In group C， the expression level of plasma NSE and S100β significantly increased after CPB (P<0.05). Meanwhile， there was no significant difference of the concentrations of NSE and S100β between the two groups before start of CPB. After termination of CPB， the expression level of plasma NSE and S100β was obviously higher in group C than that in group K (P <0.05). Conclusion Ketamine can reduce the release of NSE and S100β protein in infants after CPB， so it may attenuate the brain injury.
[Key words] Ketamine； CPB； NSE； S100β
体外循环(CPB)技术的发展极大地促进了心脏外科治疗的发展，但是目前脑外伤仍然是心脏外科术后影响预后的严重并发症之一。加之婴幼儿全身器官发育不成熟，血脑屏障发育不完善，CPB后更易引起脑损伤 ......
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