爱维治对食管手术患者血糖、血浆胰岛素、乳酸与红细胞磷酸果糖激酶活性的影响

Objective: In order to investigate the effects of actovegin administrated before anesthesia on blood glucose(BG), plasma insulin(INS), plasma lactic acid(LA) and erythrocytes glycolysis rate-limiting enzyme, phosphofructokinase(PFK) activities in patients undergoing esophagus surgery. Methods: Forty patients scheduled for esophagus surgery were randomly divided into two groups: control group and actovegin group. Isoflurane inhalation anesthesia was used in both groups and isoflurane was administrated at 1.2 MAC end-tidal concentration. Actovegin (20 mg/kg) was administrated intravenously before anesthesia in actovegin group. Blood samples were taken from peripheral win for determination of BG, plasma INS, plasma LA and erythrocytes PFK activities. Insulin sensitivity index(ISI) was calculated. Samples were obtained before anesthesia(T1). 90 min after the start of surgery (T2), 60 min after the end of surgery (T3), first postoperative morning(T4) and second postoperative morning(T3). Results: In both groups, BG was increased significantly (P＜0.05) compared with those before anesthesia. On T3, BG was significantly lower(P=0.034) in actovegin group than that in control group. On T4, there was no significant difference (P=0.732) in INS in actovegin group but significant difference (P=0.003) in control group compared with those before anesthesia, and there was significant difference in INS between two groups (P=0.035). On T4, ISI was reduced significantly (P＜0.05) compared with those before anesthesia in both groups, but ISI was significantly higher(P=0.045) in actovegin group than that in control group. On T4, there was no significant difference(P=0.055) in PFK in actovegin group but significant difference (P=0.001) in control group compared with those before anesthesia, and there was significant difference between two groups (P=0.044). On T3 there was no significant difference (P=0.114) in LA in actovegin group but significant difference(P=0.000) in control group compared with those before anesthesia, and there was significant difference between two groups (P=0.036). Conclusion: Actovegin could decrease insulin resistance and the increased reaction of blood glucose originated stress, enhance PFK activity of erythrocytes and inhibit the production of lactic acid in patients undergoing esophagus surgery activity.