盐酸右美托咪啶对重症颅脑损伤患者围术期内皮素-1的影响  

Effects of dexmedetomidine on endothelin-1 in patients with serious brain injury

作　　者：徐兴国[1] 范冰冰[2] 许忠玲[1] 

机构地区：[1]南通大学附属医院麻醉科,226001 [2]南通大学医学院

出　　处：《国际麻醉学与复苏杂志》2012年第12期801-803,共3页International Journal of Anesthesiology and Resuscitation

摘　　要：目的观察盐酸右美托咪啶对重症颅脑损伤患者围术期内皮素-1（endothelin-1，ET-1）的影响。方法重症颅脑损伤患者40例按随机数字表法随机分为盐酸右美托咪啶组（D组）和对照组（C组）（每组20例）。两组分别于麻醉诱导前（T0）、插管即刻（T1）、术毕（T2）、术后1（T3）、3d（T4）及5d（T5）晨抽取静脉血测定血浆ET-1的浓度，同时监测各时点血流动力学指标的变化情况。结果与T0点心率（HR）（107±9）次／min，平均动脉压（MAP）（125±6）mmHg（1mmHg=0．133kPa），血浆ET－1（237±27）μg几比较，C组在T1时点HR（119±12）次／min显著升高（P〈0．05），T34时点HR（70±5）次／min、MAP（82±6）mmHg和血浆ET．1浓度（122±12）μg，L降低（P〈0．05）；与T0点HR（110±11）次／min，MAP（123±7）mmHg，血浆ET-1（233±23）μg／L比较，D组在T1-5时点HR（70±5）次，min和MAP（81±6）mmHg均显著降低，T2-5时点血浆ET-1浓度（88±8）μg，L显著降低（P〈0．05）。两组HR和MAP在T1-3,血浆ET-1在T2-5时点差异具有统计学意义（P〈0．05）.C组患者中1例因并发神经源性肺水肿死亡。结论重症颅脑损伤患者围术期持续应用盐酸右美托咪啶能有效维持血液动力学稳定，降低患者血浆ET-1的浓度。Objective To explore the effects of dexmedetomidine on the level of endothelin-1 （ET-1） in blood samples of patients with serious brain injury. Methods Fourty patients with serious brain injury were assigned to 2 groups randomly （n=20 each）： dexmedetomidine group （group D） and control group （group C）. The level of ET-1 in blood samples was measured in the following time point, before induction of anesthesia （To）, after tracheal intubation （T1）, after operation （T2）, as well as on the 1st day, 3rd day and 5th day after operation （T3, T4, Ts）, and the hemodynamic parameters at these time points were recorded. Results Compared with To, HR increased significantly at T1, and HR, MAP as well as plasma ET-1 decreased at T3 in C group. And compared with To in D group, HR and MAP is lower at Ti-5 than To, while the plasma ET-1 decreased siginifieantly at T2-5. HR and MAP at T1-3, plasma ET-I at T2-5 were significantly different between the two groups （P〈0.05）. One of patient in group C die of neurogenic pulmonary edema. Conclusions Continued application of dexmedetomidine cause a decrease in the level of ET-1 and play a role in maintaining hemodynamie stability.

关 键 词：右美托咪啶 重症颅脑损伤 内皮素-1 

分 类 号：R473.6[医药卫生—护理学]