中国实用医药
中國實用醫藥
중국실용의약
CHINA PRACTICAL MEDICAL
2015年
26期
13-14
,共2页
张浩%刘志武%胡元威%季振鹏
張浩%劉誌武%鬍元威%季振鵬
장호%류지무%호원위%계진붕
右美托咪定%心脏单瓣膜置换%神经组织蛋白%神经元特异性烯醇化酶%脑保护
右美託咪定%心髒單瓣膜置換%神經組織蛋白%神經元特異性烯醇化酶%腦保護
우미탁미정%심장단판막치환%신경조직단백%신경원특이성희순화매%뇌보호
Dexmedetomidine%Isolated cardiac valve replacement%Nervous tissue protein%Neuron-specific enolase%Cerebral protection
目的：观察右美托咪定对体外循环单瓣膜置换手术(CPB-VR)患者围术期脑保护的作用。方法60例择期单瓣膜置换手术患者随机分为右美托咪定组(D组)和对照组(C组)，每组30例。D组于麻醉诱导前10 min泵注右美托咪定(1μg/kg)，术中以0.5μg/(kg·h)的速度持续泵注至患者拔管。C组用等容量的等渗生理盐水替代。于右美托咪定用药前(T0)、体外循环结束后(T1)、体外循环结束后6 h (T2)、体外循环结束后24 h T34个时间点分别采集颈静脉血检测神经组织蛋白(S-100β)和神经元特异性烯醇化酶(NSE)。结果两组患者在T1和T2时 S-100β和NSE的浓度均明显高于T0；与C组比较， D组患者S-100β和NSE的浓度在T1和T2时均降低，差异均有统计学意义(P<0.05)。结论心肺转流术可引起S-100β和NSE含量升高，右美托咪定能够降低体外循环下单瓣膜置换手术患者血清S-100β和NSE升高的水平，具有一定的脑保护作用。
目的：觀察右美託咪定對體外循環單瓣膜置換手術(CPB-VR)患者圍術期腦保護的作用。方法60例擇期單瓣膜置換手術患者隨機分為右美託咪定組(D組)和對照組(C組)，每組30例。D組于痳醉誘導前10 min泵註右美託咪定(1μg/kg)，術中以0.5μg/(kg·h)的速度持續泵註至患者拔管。C組用等容量的等滲生理鹽水替代。于右美託咪定用藥前(T0)、體外循環結束後(T1)、體外循環結束後6 h (T2)、體外循環結束後24 h T34箇時間點分彆採集頸靜脈血檢測神經組織蛋白(S-100β)和神經元特異性烯醇化酶(NSE)。結果兩組患者在T1和T2時 S-100β和NSE的濃度均明顯高于T0；與C組比較， D組患者S-100β和NSE的濃度在T1和T2時均降低，差異均有統計學意義(P<0.05)。結論心肺轉流術可引起S-100β和NSE含量升高，右美託咪定能夠降低體外循環下單瓣膜置換手術患者血清S-100β和NSE升高的水平，具有一定的腦保護作用。
목적：관찰우미탁미정대체외순배단판막치환수술(CPB-VR)환자위술기뇌보호적작용。방법60례택기단판막치환수술환자수궤분위우미탁미정조(D조)화대조조(C조)，매조30례。D조우마취유도전10 min빙주우미탁미정(1μg/kg)，술중이0.5μg/(kg·h)적속도지속빙주지환자발관。C조용등용량적등삼생리염수체대。우우미탁미정용약전(T0)、체외순배결속후(T1)、체외순배결속후6 h (T2)、체외순배결속후24 h T34개시간점분별채집경정맥혈검측신경조직단백(S-100β)화신경원특이성희순화매(NSE)。결과량조환자재T1화T2시 S-100β화NSE적농도균명현고우T0；여C조비교， D조환자S-100β화NSE적농도재T1화T2시균강저，차이균유통계학의의(P<0.05)。결론심폐전류술가인기S-100β화NSE함량승고，우미탁미정능구강저체외순배하단판막치환수술환자혈청S-100β화NSE승고적수평，구유일정적뇌보호작용。
ObjectiveTo observe cerebral protection effect in perioperative period by dexmedetomidine for cardiopulmonary bypass-isolated cardiac valve replacement (CPB-VR) patients.MethodsA total of 60 isolated cardiac valve replacement patients were randomly divided into dexmedetomidine group (group D) and control group (group C), with 30 cases in each group. Group D received dexmedetomidine (1μg/kg) in 10 min before anesthesia induction, and continuous pumping by 0.5μg/(kg·h). Group C received normal saline for replacement by the same dose. Nervous tissue protein (S-100β) and neuron-specific enolase (NSE) were detected in jugular blood samples at 4 time points, as before dexmedetomidine administration (T0), at the end of cardiopulmonary bypass (T1), in 6 h after cardiopulmonary bypass (T2), and in 24 h after cardiopulmonary bypass (T3).ResultsBoth groups had higher concentrations of S-100β and NSE at T1 and T2 than those at T0. Compared with group C, group D had lower S-100β and NSE at T1 and T2, the differences all had statistical significance (P<0.05).ConclusionCardiopulmonary bypass will lead to increased S-100β and NSE levels, while dexmedetomidine can reduce S-100β and NSE levels in isolated cardiac valve replacement patients. Dexmedetomidine also contains certain effect in cerebral protection.
