国际免疫学杂志
國際免疫學雜誌
국제면역학잡지
INTERNATIONAL JOURNAL OF IMMUNOLOGY
2014年
5期
456-458,封3
,共4页
单肺通气%右美托咪定%炎性因子%白介素-6%肿瘤坏死因子
單肺通氣%右美託咪定%炎性因子%白介素-6%腫瘤壞死因子
단폐통기%우미탁미정%염성인자%백개소-6%종류배사인자
One lung ventilation%Dexmedetomidine%Inflammatory response markers%Interleukin-6%Tumor necrosis factor-α
目的 探讨右旋美托咪定对胸科开胸手术单肺通气患者的术中血流动力学及肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)的影响.方法 选取择期全麻下行胸科开胸手术的患者40例,ASA Ⅰ～Ⅱ级,随机分为C组(对照组)和D组(右旋美托咪定组),每组20例.患者入室常规监测无创血压、心电、脉搏血氧饱和度.D组患者预先静脉泵注入右美托咪定0.6 μg/kg,15 min之后进行静脉诱导,并改为维持剂量0.4 μg/kg·h.C组患者以同样方法给予盐水后进行静脉诱导,两组静脉诱导4min后进行双腔气管插管,以纤维支气管镜调整双腔管的位置,连接麻醉机.麻醉维持用七氟烷、舒芬太尼.两组患者均记录进入手术室即刻(T1)、泵入右美托咪定15 min(T2)、气管插管后即刻(T3)、切皮即刻(T4)、单肺通气即刻(T5)和术毕即刻(T6)6个时间点的生命体征.并在进入T1、T5、T6及T7进行抽血检测TNF-α、IL-6的水平.结果 C组患者的年龄(54.2±7.1)岁、体重(65.3±9.0) kg与D组患者的年龄(53.7±6.9)、体重(63.3 ±10.1)kg相比,差异无统计学意义(P＞0.05).D组在T2、T3、T4时间点血压、心率变化比C组稳定,有统计学意义(P＜0.05).与C组对比,D组在T6、T7时间点TNF-α、IL-6均降低,有统计学意义(P＜0.05).结论 右美托咪定不仅改善术前及术后焦虑状态,维持术中稳定的血流动力学之外,还具有一定的抑制炎性因子并产生免疫保护作用.
目的 探討右鏇美託咪定對胸科開胸手術單肺通氣患者的術中血流動力學及腫瘤壞死因子(TNF-α)、白細胞介素-6(IL-6)的影響.方法 選取擇期全痳下行胸科開胸手術的患者40例,ASA Ⅰ～Ⅱ級,隨機分為C組(對照組)和D組(右鏇美託咪定組),每組20例.患者入室常規鑑測無創血壓、心電、脈搏血氧飽和度.D組患者預先靜脈泵註入右美託咪定0.6 μg/kg,15 min之後進行靜脈誘導,併改為維持劑量0.4 μg/kg·h.C組患者以同樣方法給予鹽水後進行靜脈誘導,兩組靜脈誘導4min後進行雙腔氣管插管,以纖維支氣管鏡調整雙腔管的位置,連接痳醉機.痳醉維持用七氟烷、舒芬太尼.兩組患者均記錄進入手術室即刻(T1)、泵入右美託咪定15 min(T2)、氣管插管後即刻(T3)、切皮即刻(T4)、單肺通氣即刻(T5)和術畢即刻(T6)6箇時間點的生命體徵.併在進入T1、T5、T6及T7進行抽血檢測TNF-α、IL-6的水平.結果 C組患者的年齡(54.2±7.1)歲、體重(65.3±9.0) kg與D組患者的年齡(53.7±6.9)、體重(63.3 ±10.1)kg相比,差異無統計學意義(P＞0.05).D組在T2、T3、T4時間點血壓、心率變化比C組穩定,有統計學意義(P＜0.05).與C組對比,D組在T6、T7時間點TNF-α、IL-6均降低,有統計學意義(P＜0.05).結論 右美託咪定不僅改善術前及術後焦慮狀態,維持術中穩定的血流動力學之外,還具有一定的抑製炎性因子併產生免疫保護作用.
목적 탐토우선미탁미정대흉과개흉수술단폐통기환자적술중혈류동역학급종류배사인자(TNF-α)、백세포개소-6(IL-6)적영향.방법 선취택기전마하행흉과개흉수술적환자40례,ASA Ⅰ～Ⅱ급,수궤분위C조(대조조)화D조(우선미탁미정조),매조20례.환자입실상규감측무창혈압、심전、맥박혈양포화도.D조환자예선정맥빙주입우미탁미정0.6 μg/kg,15 min지후진행정맥유도,병개위유지제량0.4 μg/kg·h.C조환자이동양방법급여염수후진행정맥유도,량조정맥유도4min후진행쌍강기관삽관,이섬유지기관경조정쌍강관적위치,련접마취궤.마취유지용칠불완、서분태니.량조환자균기록진입수술실즉각(T1)、빙입우미탁미정15 min(T2)、기관삽관후즉각(T3)、절피즉각(T4)、단폐통기즉각(T5)화술필즉각(T6)6개시간점적생명체정.병재진입T1、T5、T6급T7진행추혈검측TNF-α、IL-6적수평.결과 C조환자적년령(54.2±7.1)세、체중(65.3±9.0) kg여D조환자적년령(53.7±6.9)、체중(63.3 ±10.1)kg상비,차이무통계학의의(P＞0.05).D조재T2、T3、T4시간점혈압、심솔변화비C조은정,유통계학의의(P＜0.05).여C조대비,D조재T6、T7시간점TNF-α、IL-6균강저,유통계학의의(P＜0.05).결론 우미탁미정불부개선술전급술후초필상태,유지술중은정적혈류동역학지외,환구유일정적억제염성인자병산생면역보호작용.
Objective To investigate the effects of dexmedetomidine (Dex) on interleukin-6(IL-6),tumor necrosis factor-α (TNF-α) level and hemodynamics in the patients undergoing one lung ventilation (OLV).Method 40 Patients undergoing one lung ventilation were classified as grade Ⅰ or Ⅱ according to the American Society of Anesthesiologists grading system.The patients were randomly dividede into two groups of dexmedetomidine (group D) or control group (group C).Electrocardiogram (ECG),heart rate (HR),mean arterial pressure (MAP) and saturation of pulse oxygen (SPO2) were monitored during anecthesia.In group D,dexmedetomidine was loaded(0.6 μg/kg) 15 min before anesthesia induction and was infused(0.4 μg/kg/h) during surgery.Group C received saline.In both groups,anesthesia was maintained with sevoflune and sufentanil.ECG,HR and MAP were record before infusion of dexmedetomidine or saline(T1),after the infusion of dexmedetomidine or saline (T2),after the induction of anesthesia (T3),at the beginning of operation (T4),during OLV (T5),and at the discontinuance of intravenous anesthetics(T6).Samples of peripheral blood were taken before infusion of dexmedetomidine or saline(T1),OLV(T5),at the discontinuance of intravenous anesthetics (T6),and 2 hour after the operation (T7).TNF-α and IL-6 were analyzed in the blood samples.Result The age and weight of patients in group C are (54.2 ± 7.1) years old and (65.3 ± 9.0) kg,in group D are (53.7 ±6.9) years old and(63.3 ± 10.1) kg,there is no statistical difference between two groups(P ＞0.05).the concentration of IL-6 and TNF-α increased successively at all the time points in two groups(P ＜ 0.05).The concentration of TNF-α and IL-6 in group D were lower than that in group C at T6,T7 time points during the experimental period (P ＜ 0.05).The HR and MAP values in group D at T2,T3 and T4 time points were lower than that at T1 time point(P ＜0.05),but the HR and MAP values in group C at T2 and T3 time point were significantly higher than that at T1 time point (P ＜ 0.05).Conclusion Dexmedetomidine can inhibit inflammatory response of the patients undergoing OLV.
