摘要
目的:研究右美托咪定对体外循环下瓣膜置换术中心肌缺血再灌注损伤的影响。方法:选择2015年3月至2017年12月在湖北医药学院附属东风医院进行体外循环下二尖瓣置换术的54例患者作为研究对象,随机分为接受右美托咪定干预及常规麻醉的D组、接受常规麻醉的C组。观察两组苏醒时间、拔管时间、ICU停留时间、术后住院时间等围术期指标。手术前及手术后24 h,测定血清中心肌损伤指标、应激激素、氧化及炎症反应指标的含量。结果:D组患者苏醒时间、拔管时间、ICU停留时间、术后住院时间等均小于C组。手术后24 h,两组患者血清中CK-MB、cTnI、人内皮素-1(ET-1)、NO、心型脂肪酸结合蛋白(H-FABP)、皮质醇(Cor)、去甲肾上腺素(NE)、肾上腺素(E)、IL-1β、TNF-α、丙二醛(MDA)的含量高于手术前,FT3、FT4、IL-10、谷胱甘肽过氧化物酶(GSH-Px)的含量低于手术前且D组患者手术后24 h血清中CK-MB、cTnI、ET-1、NO、H-FABP、Cor、NE、E、IL-1β、TNF-α、MDA的含量低于对照组,FT3、FT4、IL-10、GSH-Px的含量高于对照组。结论:右美托咪定干预能够减轻体外循环下瓣膜置换术中的心肌缺血再灌注损伤。
Objective:To study the effect of dexmedetomidine on myocardial ischemia reperfusion in-jury during valve replacement under cardiopulmonary bypass.Methods:54 patients who underwent mitral valve replacement under cardiopulmonary bypass in Dongfeng hospital affiliated to Hubei university of medicine be-tween March 2015 and December 2017 were chosen as the research subjects and randomly divided into the group D who accepted dexmedetomidine intervention and general anesthesia and the group C who accepted gen-eral anesthesia.the recovery time,extubation time,ICU stay time and postoperative hospitalization time were ob-served.the serum levels of myocardial injury indexes,stress hormones,oxidizing reaction indexes and inflam-matory response indexes were measured before surgery and 24 hours after surgery.Results:The recovery time,extubation time,ICU stay time and postoperative hospitalization time in group D were smaller than those in group C.24 hours after surgery,serum CK-MB,cTnI,endothelin-1(ET-1),NO,H-FABP,cortisol(Cor),norepinephrine(NE),epinephrine(E),IL-1β,TNF-αand malondia ldehyde(MDA)levels of both groups of patients were higher than those before surgery whereas FT3,FT4,IL-10 and glutathione peroxidase(GSH-Px)levels were lower than those before surgery,and serum CK-MB,cTnI,ET-1,NO,H-FABP,Cor,NE,E,IL-1β,TNF-αand MDA levels of group D 24 hours after surgery were lower than those of control group whereas FT3,FT4,IL-10 and GSH-Px levels were higher than those of control group.Conclusions:Dexmedetomidine intervention can reduce the myocardial ischemia reperfusion injury during valve replacement under cardiopulmonary bypass.
作者
王茜
闵新文
李东峰
李兴朝
WANG Qian;MIN Xinwen;LI Dongfeng;LI Xingchao(Department of Cardiology,Dongfeng Hospital Affiliated to Hubei University of Medicine,Shiyan 442000,China)
出处
《心肺血管病杂志》
2019年第12期1248-1252,共5页
Journal of Cardiovascular and Pulmonary Diseases
关键词
体外循环
缺血再灌注
右美托咪定
炎症反应
应激反应
Cardiopulmonary bypass
Ischemia reperfusion
Dexmedetomidine
Inflammatory response
Stress response
