氢溴酸高乌甲素对止血带引起肢体缺血再灌注炎性细胞因子影响-effect of lappaconitine hydrobromide on inflammatory cytokines in limb ischemia-reperfusion induce by tourniquet.docxVIP

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氢溴酸高乌甲素对止血带引起肢体缺血再灌注炎性细胞因子影响-effect of lappaconitine hydrobromide on inflammatory cytokines in limb ischemia-reperfusion induce by tourniquet.docx

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氢溴酸高乌甲素对止血带引起肢体缺血再灌注炎性细胞因子影响-effect of lappaconitine hydrobromide on inflammatory cytokines in limb ischemia-reperfusion induce by tourniquet

ABSTRACTObjective：Toresearchtheeffectsoflappaconitehydrobromideinjectiononinflammatorycytokinesandmyocardialenzymeduringoperation,whichtourniquetproducedlowlimbischemiareperfusion.Methods：Fortypatientswhoundergoingunilateralknee-joint,ankleornearanklesurgery,ASAI-II,wererandomlydividedintotwogroups,20patientsinlappaconitehydrobromidegroup(GroupL)andanother20patientsincontrolgroup(GroupC).GroupL:intravenousinjectedlappaconitehydrobromide8mgslowlybeforelowlimbtourniquetinflation,andtourniquetdeflatedafter60-70minutes.GroupC:intravenousinjectednormalsaline4mlslowly.2-3mlbloodsamplesweretakenfromthepatientstodetectedTNF-α,IL-1β,CKconcentrationbeforetourniquetinflation(T0),10min(T1)and30minaftertourniquetdeflation(T2).RecordNIBP,SpO2andHRatbeforetourniquetinflation(t0),beforetourniquetdeflation,tourniquetdeflation,5minaftertourniquetdeflation(t1),20minaftertourniquetdeflation(t2).Results：Thesystolicpressure(SP)anddiastolicbloodpressure(DP)atthetimebeforetourniquetdeflationsignificantlyincreasedthant0intwogroups(P＜0.05).SPandDPsignificantlydecreasedattourniquetdeflationthanbeforetourniquetdeflationinGroupC(P＜0.05).SP,DPandHRwerelowerinGroupLthanGroupCbeforetourniquetdeflationandtourniquetdeflation.IL-1βandCKincreasedatT1andT2thanT0(P＜0.05),IL-1βandCKwereloweratT1andT2inGroupLthaninGroupC.TNF-αincreasedatT1andT2thanT0intwogroups(P0.05,P0.01).TNF-αinGroupLwerelowerthaninGroupCatT1andT2(P0.05).Conclusion：TNF-α,IL-1β,CKconcentrationdecreasedthroughintravenousinjectedlappaconitehydrobromide8mgslowlybeforetourniquetinflation,haemodynamicsandSpO2wereinnormalafterreceivingthisdoseoflappaconitehydrobromide.Keyword：Ischemia-reperfusion;Lappaconitine;Tourniquet;Cellfactor;Myoca-rdialenzyme目录第1章引言············································································································1第2章材料与方法·································································································32.1病例分组及方法···································································