【摘要】 目的探讨七氟醚预处理对体外循环(CPB)手术患者围术期血心肌特异性mi RNA-1(mi R-1)表达水平的影响,分析七氟醚浓度和mi R-1表达水平变化的相关性,进一步阐明七氟醚预防围术期心肌缺血损伤的机制。方法将2013年10月至2014年6月该院胸心外科拟在CPB下行心脏直视手术的40例患者随机分为A、B两组。A组20例行七氟醚预处理;B组20例行常规CPB麻醉。抽取两组患者术前5 min、术中(术后鱼精蛋白拮抗肝素后5 min)和术后6 h血液标本,采用实时荧光定量聚合酶链反应方法检测不同时间点血mi R-1含量。结果两组患者术中、术后6 h血液标本中mi R-1含量明显高于术前,且相应时间点A组患者血mi R-1含量低于与B组,差异均有统计学意义(P<0.05);七氟醚预处理浓度与术中及术后6 h血mi R-1升高的倍数呈负相关(r=-0.41、-0.81,P<0.05)。结论七氟醚预处理可降低血mi R-1含量,减轻CPB期间心肌累积损伤,且在一定浓度范围内七氟醚预处理浓度越高,术中及术后6 h血mi R-1含量升高倍数越小。更多还原

【Abstract】 Objective To approach the effect of expression level on specific micro RNA-1(mi R-1) in pretreatment with sevoflurane for patients accepted the intracardiac surgery under cardiopulmonary bypass(CPB) and analyze the correlation between sevoflurane concentration and mi R-1 level to set forth the mechanism of prevention from perioperative myocardial ischemia in-jury with sevoflurane further. Methods A total of 40 patients planned to have intracardiac surgery under CPB from October2013 to June 2014 were divided into two groups. Group A(20 cases) was treated with sevoflurane in advance and group B with routine CPB anesthesia. The blood samples at the time of preoperative 5 minutes,during the operation(protamine-against-heparin5 min after the operation) and postoperative 6 hours were collected by the two groups. It is adopted real-time fluoresence quantitative polymerase chain reaction to test serum mi R-1 content at various time. Results The serum mi R-1 contents during the operation and 6 h after CPB operation were significantly higher than those before the operation between the two groups. Compare with Group A at the same time,the serum mi R-1 content in Group A was lower than that of group B. The difference had statistical significance(P<0.05); The mi R-1 levels in group A had a strong negative correlation with the concentration of sevoflurane(r=-0.41,-0.81,P<0.05). Conclusion Pretreatment with sevoflurane may decrease erum mi R-1 content,relieve myocardial ischemia injury during the CPB. Under certain scope,the higher the pretreatment concentration with sevoflurane the smaller the serum mi R-1content multipler during the operation and 6 h after the operation.更多还原