【摘要】 目的研究利多卡因对非体外循环冠状动脉旁路移植术(OPCAB)病人活性氧的影响。方法30例择期行OPCAB的病人随机分为对照组(C组)和利多卡因组(L组),每组15例,两组麻醉方法相同。L组于麻醉诱导后静脉注射利多卡因2mg/kg,继以2mg/(kg.h)持续泵入至术毕;C组给予等量0.9%氯化钠注射液。分别在麻醉诱导后手术前(T1)、乳内动脉游离结束肝素化后即刻(T2)、手术结束(T3)、术后24h(T4)采集中心静脉血,用分光光度法检测超氧化物歧化酶(SOD)及丙二醛(MDA)。同时记录血流动力学指标及术后早期临床资料、ICU滞留时间、住院时间等。结果SOD两组组内各时点间和组间变化都不明显(P>0.05);MDA在L组各时点间变化无明显差异(P>0.05),C组MDA在T4比T1显著升高,分别为(7.4±2.3)nmol/ml vs(3.7±1.1)nmol/ml,(P<0.01),MDA在T4时点两组间比较差异显著,数值为(7.4±2.3)nmol/ml vs(4.7±1.3)nmol/ml(,P<0.05);L组病人术后ICU滞留时间、住院时间较C组显著缩短(P<0.05)。结论利多卡因可以抑制OPCAB病人活性氧浓度的升高,具有一定的心肌保护作用。更多还原

【Abstract】 Objective To study the effect of lidocaine on serum reactive oxygen species(ROS) in patients undergoing off-pump coronary artery bypass graft(OPCAB).Methods Thirty patients(23 males,7 females) undergoing OPCAB were randomly divided into control group(group C) and lidocaine group(group L),15 in each group.Patients in group L were anesthetized with intravenous lidocaine(2mg/kg) followed by infusion of lidocaine 2mg/(kg·h) till the end of operation.Patients in group C were given the same volume of 0.9% sodium chloride at the same amount.Blood samples were taken from the internal jugular vein before operation(T1),immediately after heparinization(T2),immediately after operation(T3) and 24h after operation(T4).Superoxide dismutase(SOD) and malindialdehyde(MDA) were detected by spectrometry.Results No significant difference was found in SOD at different time points between the two groups(P>0.05).No significant change of MDA was observed at different time points in group L.The MDA level was significantly higher in group C at T4 than at T1(7.4 nmol/ml±2.3nmol/ml vs 3.7nmol/ml±1.1nmol/ml,P<0.01).However,a significant difference was found in MDA at T4 between the two groups(7.4nmol/ml±2.3nmol/ml vs 4.7nmol/ml±1.3nmol/ml,P<0.05).The stay time of group L in ICU and hospital was significantly shorter than that of group C(P<0.05).Conclusion Lidocaine can inhibit the release of ROS in patients undergoing OPCAB.更多还原