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[1]刘建东,卢承志,林 斌,等.甲泼尼龙在颈椎前路减压术中的应用[J].医学研究与战创伤救治(原医学研究生学报),2013,15(04):355-357.[doi:10.3969/j.issn.1672-271X.2013.04.012]
　LIU Jian-dong,LU Cheng-zhi,LIN Bin,et al.Clinical significance of perioperative methylprednisolone on anterior cervical decompression operation[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2013,15(04):355-357.[doi:10.3969/j.issn.1672-271X.2013.04.012]
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甲泼尼龙在颈椎前路减压术中的应用()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第15卷
期数:
2013年04期
页码:
355-357
栏目:
出版日期:
2013-08-05

文章信息/Info

Title:
Clinical significance of perioperative methylprednisolone on anterior cervical decompression operation
作者:
刘建东1; 卢承志1; 林 斌2; 周 亮2; 张文龙1; 姚猛飞1
363000 福建漳州,解放军175医院,1.麻醉科,2.骨科
Author(s):
LIU Jian-dong1; LU Cheng-zhi1; LIN Bin2; ZHOU Liang2; ZHANG Wen-long1; YAO Meng-fei1
1.Department of Anesthesiology,2.Department of Orthopedics,175 Hospital of PLA,Zhangzhou,Fujian 363000,China
关键词:
脊髓型颈椎病;  甲泼尼龙;  颈椎前路减压术;  再灌注损伤;  炎症反应
Keywords:
cervical spondylotic myelopathy;  methylprednisolone;  anterior cervical decompression operation;  ischemical reperfusion injury;  inflammatory response
分类号:
R687.3
DOI:
10.3969/j.issn.1672-271X.2013.04.012
文献标志码:
A
摘要:
目的 探讨甲泼尼龙(MP)在脊髓型颈椎病(CSM)前路减压术中的应用价值。 方法 选择行颈椎前路减压术的CSM 50例,随机分为甲泼尼龙组(MP组)和对照组(C组),每组25例。MP组给予MP 30 mg/kg,C组予与等容量生理盐水。分别于麻醉诱导前(T1),术后1 h(T2),术后6 h(T3),术后24 h(T4)抽取静脉血,用酶联免疫吸附法(ELISA)测定血浆肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及超氧化物歧化酶(SOD)的浓度。 结果 两组患者血浆TNF-α、IL-6的浓度,在T2～T4各时点与术前比较均明显增加(P<0.01),SOD浓度在T2、T3时点均明显高于T1时点(P<0.05); MP组血浆TNF-α和IL-6浓度T2～T4时点明显低于C组(P<0.01),SOD浓度T2、T3时点明显高于C组(P<0.05)。 结论 甲泼尼龙能抑制颈椎前路减压术中血浆TNF-α和IL-6的释放,保护SOD活性,从而减少再灌注损伤,减轻炎症反应。
Abstract:
Objective To investigate the effects of methylprednisolone(MP)on patients with cervical spondylotic myelopathy(CSM)underwent anterior decompression.Methods Fifty patients scheduled for elective anterior decompression were randomly divided into two groups of 25 each:control group(C)and methylprednisolone group(MP).Group MP received methylprednisolone 30 mg/kg and group C received same volume of normal saline instead of methylprednisolone as control.Blood samples were taken from vein for determination of plasma TNF-α,IL-6 and SOD concentrations before induction of anesthesia(T1),1 h after(T2),6 h after(T3)and 24 h(T4)after termination of operation.All of these was estimated by enzyme-linked immunosorbent assay(ELISA).Results There was no significant difference between two groups in plasma TNF-α,IL-6 and SOD level at T1.The level of TNF-α,IL-6 at T2-T4 and SOD at T2-T3 was significantly increased compared with that before operation in both groups.However,the plasma concentrations of TNF-α and IL-6 were significantly lower at T2-T4 while the concentration of SOD was significantly higher at T2-T3 in group MP than those in group C.Conclusion Methylprednisolone can reduce the increased amplitude of plasma levels of TNF-α and IL-6,whereas enhance the increased amplitude of the plasma SOD levels in anterior cervical decompression operation.In other words,Methylprednisolone posseses the effect to decrease ischemical reperfusion injury and down-regulate inflammatory response during operation.

参考文献/References:

[1] 马大年,李 健,时梦猇.颈椎前路减压钛网植骨钛板固定治疗脊髓型颈椎病[J].东南国防医药,2012,14(1):66- 67.
[2] 贾连顺,史建刚.重视脊髓型颈椎病的诊断与严格手术指征[J].中华骨科杂志,2002,22(1):58-60.
[3] Connor PA,McCormack O,Gavin C,et al.Methylprednisolone in acute spinal cord injuries[J].J Med Sci,2003,172(1):24-26.
[4] Tsutsumi S,Ueta T,Shiba K,et al.Effects of the second national acute spinal cord injury study of high-dose methylprednisolone therapy on acute cervical spinal cord injury-results in spinal injuries center[J].Spine,2006,31(26):2992-2996.
[5] Smith JS,Anderson R,Pham T,et al.Role of early surgical decompression of the intradural space after cervical spinal cord injury in an animal model[J].J Bone Joint Surg Am,2010,92(5):1206-1214.
[6] 周大凯,张忠民,金大地.颈前路手术治疗脊髓型颈椎病临床疗效的影响因素分析[J].脊柱外科杂志,2008,6(4):210-213.
[7] Aosasa S,Ono S,Mochizuki H,et al.Mechanism of the inhibitory effect of protease inhibitor on tumor necrosis factor alpha production of monocytes[J].Shock,2001,15(2):101-105.
[8] Pallua N,Low JF,von Heimburg D.Pathogenic role of interleukin-6 in the development of sepsis.Part Ⅱ:significance of anti-interleukin-6 and anti-soluble interleukin-6 receptor-alpha antibodies in a standardized murine contact burn model[J].Crit Care Med,2003,31(5):1495-1501.
[9] Hosseinzadeh H,Parvardeh S,Asl MN,et al.Effect of thymoquinone and Nigella sativa seeds oil on lipid peroxidation level during global cerebral ischemia-reperfusion injury in rat hippocampus[J].Phytomedicine,2007,14(9):621-627.
[10] Christie SD,Comeau B,Myers T,et al.Duration of lipid peroxidation after acute spinal cord injury in rats and the effect of methylprednisolone[J].Neurosurg Focus,2008,25(5):E5.
[11] Kim YT,Caldwell JM,Bellamkonda RV.Nanoparticle-mediated local delivery of methylprednisolone after spinal cord injury[J].Biomaterials,2009,30(13):2582-2590.
[12] Leypold BG,Flanders AE,Schwartz ED,et al.The impact of methylprednisolone on lesion severity following spinal cord injury[J].Spine,2007,32(3):373-378.

相似文献/References:

[1]马大年,李 健,时梦猇.颈椎前路减压钛网植骨钛板固定治疗脊髓型颈椎病[J].医学研究与战创伤救治(原医学研究生学报),2012,14(01):66.

备注/Memo

备注/Memo:
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更新日期/Last Update: 2013-08-05