帕瑞昔布钠对脑肿瘤切除术患者炎症反应的影响及脑保护作用

doi:10.6040/j.issn.1671-7554.0.2015.998

摘要/Abstract

摘要： 目的观察帕瑞昔布钠对脑肿瘤切除术患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、神经元特异性烯醇化酶(NSE)与S100β蛋白的影响,探讨其脑保护作用。方法将40例择期全麻下开颅脑肿瘤切除术患者随机分为帕瑞昔布钠组和空白对照组,每组20例。帕瑞昔布钠组麻醉诱导前和诱导后12 h分别静注帕瑞昔布钠40 mg(溶于5 mL生理盐水),空白对照组相同方式静注生理盐水5 mL。检测两组患者入室后(T₀)、切除肿瘤时(T₁)、手术结束时(T₂)、术后6 h(T₃)、术后24 h(T₄)血清TNF-α、IL-1β、NSE及S100β蛋白的浓度。结果与空白对照组相比,帕瑞昔布钠组患者T₁~T₄时血清TNF-α、IL-1β、NSE和S100β蛋白水平明显降低(P<0.01)。与T₀时比较,两组患者T₁~T₄时血清TNF-α、IL-1β、NSE和S100β蛋白水平明显增高(P<0.01)。结论帕瑞昔布钠可抑制脑肿瘤切除术患者TNF-α、IL-1β的表达,降低血清中NSE和S100β蛋白水平,其脑保护作用可能与抑制炎症反应有关。

关键词: S100β蛋白, 帕瑞昔布钠, 白细胞介素-1β, 神经元特异性烯醇化酶, 脑保护, 肿瘤坏死因子-α

Abstract: Objective To observe the effects of parecoxibsodium on serum levels of tumor necrosis factor-α(TNF-α), interleukin 1β(IL-1β), neuron-specific enolase(NSE)and S100β protein in patients undergoing brain tumor surgery, and to investigate its neuroprotection effects. Methods Forty patients undergoing brain tumor surgery under general anesthesia were randomly divided into the parecoxibsodium group and the control group, twenty in each group. The parecoxibsodium group was injected intravenously 40 mg parecoxibsodium(dissolved in 5 mL saline solution)before and 12 hours after the anesthesia induction, the control group received 5 mL saline solution in the same way. The serum levels of TNF-α, IL-1β, NSE and S100β protein were measured before anesthesia induction(T₀), after removing the tumor(T₁), the completion of surgery(T₂), 6 h after surgery(T₃)and 24 h after surgery(T₄). Results Compared with the control group, the levels of TNF-α, IL-1β, NSE and S100β protein in the parecoxibsodium group obviously decreased at the time points of T₁-T₄(P<0.01). Compared with the time point of T₀, the levels of TNF-α, IL-1β, NSE and S100β protein in two groups obviously increased at the time points of T₁-T₄(P<0.01). Conclusion Parecoxibsodium can inhibit the expressions of TNF-α, IL-1β and decrease the levels of NSE and S100β protein in the serum, and it can provide neuroprotection effects through alleviating the inflammation response during brain tumor surgery.

Key words: Tumor necrosis factor-α, Parecoxibsodium, Interleukin 1β, Neuroprotection, Neuron-specific enolase, S100β protein

中图分类号:

R971

于玉娟,高成杰,王晓鹏,李波. 帕瑞昔布钠对脑肿瘤切除术患者炎症反应的影响及脑保护作用[J]. 山东大学学报（医学版）, 2016, 54(6): 65-68.

YU Yujuan, GAO Chengjie, WANG Xiaopeng, LI Bo. Effects of parecoxibsodium on inflammatory response and its neuroprotection in patients undergoing brain tumor surgery[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(6): 65-68.

参考文献

[1] Stella N. Neuroscience inflammation to rebuild a brain[J]. Science, 2012, 338(6112):1303-1304.
[2] Martinez V, Belbachir A, Jaber A, et al. The infuence of timing of administration on the analgesic efficacy of parecoxib in orthopedic surgery[J]. Anesth Analg, 2007, 104(6):1521-1527.
[3] Wang N, Guo QL, Ye Z, et al. Preconditioning of intravenous parecoxib attenuates focal cerebral ischemia/reperfusion injury in rats[J]. Chin Med J(Engl), 2011, 124(13):2004-2008.
[4] Kunz A, Dirnagl U, Mergenthaler P. Acute pathophysiological processes after ischaemic and traumatic brain injury[J]. Best Pract Res Clin Anaesthesiol, 2010, 24(4):495-509.
[5] Gaur V, Kumar A. Effect of nonselective and selective COX-2 inhibitors on memory dysfunction, glutathione system, and tumor necrosis factor alpha level against cerebral ischemia reperfusion injury[J]. Drug Chem Toxicol, 2012, 35(2):218-224.
[6] 王波, 旷昕, 田绍文. 帕瑞昔布钠的作用机制及最新进展[J].海南医学, 2014, 25(23):3496-3499. WANG Bo, KUANG Xin, TIAN Shaowen. Mechanisms and progress of parecoxib sodium[J]. Hainan Medical Journal, 2014, 25(23):3496-3499.
[7] Peng M, Wang YL, Wang FF, et al. The cyclooxygenase-2 inhibitor parecoxib inhibits surgery-induced proinflammatory cytokine expression in the hippocampus in aged rats[J]. J Surg Res, 2012, 178(1):e1-e8.
[8] 张摇威, 谢扬, 陈郁强, 等. 颅脑损伤患者急性期血清TNF-α和IL-1β水平的动态变化分析[J].现代医院, 2014, 14(3):18-20. ZHANG Yaowei, XIE Yang, CHEN Yuqiang, et al. Analyze the dynamic changes of serum TNF-α, IL-1β levels in patients with traumatic brain injury acute phase[J]. Modern Hospital, 2014, 14(3):18-20.
[9] 郭梅凤, 孙宝玲. 急性颅脑损伤患者血清TNF-α和IL-2水平的变化及临床意义[J].实用临床医学, 2012, 13(3):1-3. GUO Meifeng, SUN Baoling. Clinical significance of changes in serum TNF-α and IL-2 levels in patients with acute craniocerebral injury[J]. Practical Clinical Medicine, 2012, 13(3):1-3.
[10] 赵卫海, 陈炼, 余国栋. 血清TNF-α,IL-1,IL-6,IL-8在急性颅脑损伤后含量变化及意义[J].中国实用神经疾病杂志, 2013, 16(16):22-23. ZHAO Weihai, CHEN Lian, YU Guodong. Clinical significance and content changes of serum TNF-α, IL-1, IL-6 and IL-8 in patients with acute craniocerebral injury[J]. Chinese Journal of Practical Neruous Diseases, 2013, 16(16):22-23.
[11] Savard A, Lavoie K, Brochu ME, et al. Improvement of neuronal IL-1β in acquired brain lesions in a rat model of neonatal encephalopathy[J]. J Neuroinflammation, 2013, 10(1):110.
[12] 陈勇, 杜晓红, 金夏, 等. 星状神经节阻滞对老龄大鼠血清S100β蛋白、NSE及术后认知功能的影响[J]. 临床麻醉学杂志, 2013, 29(10): 1020-1023. CHEN Yong, DU Xiaohong, JIN Xia, et al. Effects of stellate ganglion block on serum S100β, NSE and postoperative cognitive function in aged rats[J]. J Clin Anesthesiol, 2013, 29(10):1020-1023.
[13] Thelin EP, Johannesson L, Nelson D, et al. S100B is an important outcome predictor in traumatic brain injury[J]. J Neurotrauma, 2013, 30(7):519-528.
[14] 宋直雷, 孟凡民, 张加强. 右美托咪定在颅内动脉瘤手术中的脑保护作用[J].中华实用诊断与治疗杂志, 2013, 27(9):859-861. SONG Zhilei, MENG Fanmin, ZHANG Jiaqiang. Neuroprotective effect of dexmedetomidine in the brain hemangioma surgery[J]. Journal of Chinese Practical Diagnosis and Therapy, 2013, 27(9):859-861.
[15] Gopez JJ, Yue H, Vasudevan R, et al. Cyclooxygenase-2-specific inhibitor improves functional outcomes, provides neuroprotection and reduces inflammation in a rat model of traumatic brain injury[J]. Neurosurgery, 2005, 56(3):590-604.
[16] Ye Z, Wang N, Xia P, et al. Delayed administration of parecoxib, a specific COX-2 inhibitor, attenuated postischemic neuronal apoptosis by phosphorylation Akt and GSK-3β[J]. Neurochem Res, 2012, 37(2):321-329.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed