地塞米松对肢体缺血-再灌注时深静脉血栓形成危险的影响  

Effect of dexamethasone on the risk for deep vein thrombosis during reperfusion after ischemia of pelvic limb

作　　者：黄新冲[1] 曹苏[1] 沈施仁[1] 

机构地区：[1]南通大学附属医院麻醉科,226001

出　　处：《江苏医药》2009年第6期678-679,共2页Jiangsu Medical Journal

摘　　要：目的研究地塞米松对肢体缺血-再灌注(I-R)后红细胞内过氧化脂质(LPO)和白细胞介素8(IL-8)的影响,探讨其对深静脉血栓形成(DVT)危险的防治作用。方法54例择期骨科手术患者,随机分非缺血对照组(C组)、I-R组(A组)、地塞米松治疗组(B组)。B组在缺血前静注地塞米松10mg,再灌注时再静注地塞米松5mg;A组不用地塞米松;C组不用止血带和地塞米松。各组在再灌注前(手术结束)、再灌注后10、20min抽血测定红细胞中LPO和IL-8含量。结果与再灌注前相比,再灌注后10、20min,A组LPO均显著增高(P<0.01);再灌注后20min,A组IL-8升高(P<0.05)。与A组比较,再灌注后20min,B组LPO显著减少(P<0.01),IL-8显著减少(P<0.05)。结论肢体I-R后红细胞内LPO和IL-8的增加是DVT的危险因素,地塞米松可减少I-R肢体DVT的危险。Objective To study the effects of dexamethasone on erythrocyte lipid peroxide （LPO） and interleukin-8 （IL-8） during reperfusion after ischemia of pelvic limb and explore its role of prevention and treatment for deep vein thrombosis （DVT）. Methods Fifty-four patients undergoing orthopedic surgery were randomly divided into non-ischemic control group（C）, I-R group（A） and dexamethasone treatment group（B）. Intravenous dexamethasone 10 mg before ischemia and 5 mg at the beginning of reperfusion in group B. LPO and IL-8 in red blood cells（RBC） were measured before reperfusion and at 10,20 min after reperfusion. Results The LPO in RBC was significantly higher at 10 and 20 min and IL-8 at 20 min after reperfusion than those before （P〈0. 01 and P〈0. 05） in group A. LPO and IL-8 were lower in group B than those in group A at 20 min after reperfusion （P〈0. 01 and P〈0.05）. Conclusion. The increases of LPO and IL-8 in RBC after I-R of the limbs are the risk factors for DVT, which may be reduced by dexamethasone injection brfore ischemia.

关 键 词：地塞米松 再灌注损伤 脂质过氧化 白细胞介素8 深静脉血栓形成 

分 类 号：R614[医药卫生—麻醉学]