右美托咪啶对颅内占位围手术期脑保护的临床研究  

Protective effect of dexmedetomidine on perioperative patients with intracranial spaceoccupying lesion

作　　者：陈志辉[1] 纪浩聪[1] 储钟芳[1] 高晓枫[1] 

机构地区：[1]广东省惠州市第一人民医院,广东惠州516000

出　　处：《海南医学院学报》2012年第4期492-494,497,共4页Journal of Hainan Medical University

基　　金：中国高校医学期刊临床专项资金项目(11221092)~~

摘　　要：目的:研究应用右美托咪啶在颅内占位患者围手术期的脑保护作用,探讨其可能的作用机理及途径。方法:将60例择期颅内占位性病变患者随机分为右美托咪啶组(A组)及安慰剂组(B组),比较两组的血流动力学稳定情况、脑氧摄取率、S100β蛋白、TNF-α、IL-6、IL-8、乳酸水平、脑型肌酸激酶同工酶、神经元特异性烯醇化酶等指标。结果:T2、T3、T4、T5时刻A组的血流动力学稳定情况优于B组;A组的脑氧摄取率[(51.3±3.4)%]高于B组的[(42.6±4.2)%],术后A组的S100β蛋白[(1.33±0.32)ng/mL]、TNF-α[(44.1±4.2)pg/mL]、IL-6[(236.3±32.7)pg/mL]、IL-8[(285.3±34.5)pg/mL]、乳酸水平[(6.7±2.3)mmol/L]、脑型肌酸激酶同工酶(CK-BB)[(5.4±2.1)IU/L]、神经元特异性烯醇化酶(NCE)[(6.4±1.4)ng/L]等指标水平均低于B组(P<0.05)。结论:右美托咪啶对神经外科颅内占位性病变患者围手术期有稳定血流动力学水平、提高脑氧摄取率、降低手术及麻醉的脑损伤的作用。Objective： To explore protective effect of dexmedetomidine on perioperative patients with intracranial spaceoccupying lesion,and to discuss its possible mechanism.Methods：A total of 60 patients with intracranial space-occupying lesions were randomly divided into the dexmedetomidine group（A） and the placebo group（B）.Hemodynamic stability,cerebral oxygen uptake rate,level of S100β protein,TNF-α,IL-6,IL-8,lactic acid,brain type creatine kinase isozyme,neuronspecific enolase were measured and compared.Results：Patients in group A had better hemodynamic stability at T2,T3,T4,T5 time than group B;Cerebral oxygen uptake rate of group A（51.3 ± 3.4）% was significantly higher than group B（42.6 ± 4.2）%,patients in group A showed lower levels of S100β protein（1.33 ± 0.32） ng/mL,TNF-α（44.1 ± 4.2） pg/mL,IL-6（236.3 ± 32.7） pg/mL,IL-8（285.3 ± 34.5） pg/mL,lactic acid（6.7 ± 2.3） mmol/L,brain-type creatine kinase isozyme（5.4 ± 2.1 IU/L）,neuron-specific enolase（6.4 ± 1.4） ng/L than group B（P 0.05）.Conclusions：Dexmedetomidine is helpful in stabilizing hemodynamics level,increasing cerebral oxygen uptake rate,decreasing cerebral injury due to surgery and anesthesia.

关 键 词：右美托咪啶 颅内占位 围手术期 脑保护 

分 类 号：R651.15[医药卫生—外科学]