论文部分内容阅读
目的 研究异丙酚对肾小球、肾小管功能的影响。方法 无肾脏疾病的全麻病人 2 5例 ,随机分为异丙酚麻醉组 (n=13)和安氟醚麻醉组 (n=12 ) ,分别于麻醉诱导前和麻醉诱导后 1、2、3、2 4h留取血及尿标本 ,检测血及尿肌酐、尿素氮、尿酸、β2 -微球蛋白 (β2 - MG)、以及尿白蛋白 (Alb)、免疫球蛋白G(Ig G)、p H和尿蛋白定性等。结果 两组病人麻醉诱导后尿 β2 - MG、Alb和 Ig G较诱导前明显增高 (P<0 .0 1) ,尿蛋白定性呈阳性。麻醉诱导后 3h,异丙酚麻醉组尿液尿酸浓度由诱导前 (4 1.0 6± 14.18) m g· dl- 1升为 (74.2 6± 41.2 9) mg· dl- 1 (P<0 .0 5 )。血尿酸由 (4 .5 0± 0 .87) m g· dl- 1降为 (3.2 0± 0 .89)mg· dl- 1 (P<0 .0 5 )。异丙酚组尿酸清除率较安氟醚明显升高 ,分别为 (18.5 2± 11.93) m l· m in- 1和(10 .38± 6 .2 2 ) ml· m in- 1 (P<0 .0 5 )。其他指标无明显变化。结论 异丙酚和安氟醚麻醉引起一过性肾小球滤过屏障和肾小管重吸收功能障碍 ;异丙酚麻醉时尿酸排泄增加 ,有利于痛风病人的麻醉。
Objective To investigate the effects of propofol on glomerular and renal tubular function. Methods Twenty-five general anesthesia patients without renal disease were randomly divided into propofol anesthesia group (n = 13) and enflurane anesthesia group (n = 12), before anesthesia induction and after induction of anesthesia, Blood and urine creatinine, urea nitrogen, uric acid, β2 - microglobulin (β2 - MG) and Alb, Ig G, p H and urine protein qualitative and so on. Results Urinary β2 - MG, Alb and Ig G were significantly increased in both groups after induction of anesthesia (P <0.01), and urine protein was qualitatively positive. Three hours after the induction of anesthesia, urinary uric acid concentration in propofol anesthesia group increased from (4.106 ± 14.18) mg · dl-1 to (74.26 ± 41.29) mg · dl-1 before induction (P <0.05 ). Serum uric acid decreased from (4.5 ± 0.87) m g · dl-1 to (3.2 ± 0.89) mg · dl-1 (P <0.05). The clearance rate of uric acid in propofol group was significantly higher than that of enflurane (18.5 2 ± 11.93 ml · m in- 1 and (10.38 ± 6.22) ml · m-1, respectively .0 5). Other indicators no significant change. Conclusion Propofol and enflurane cause transient glomerular filtration barrier and renal tubular reabsorption dysfunction; propofol anesthesia increased uric acid excretion, is conducive to gout patients with anesthesia.