右美托咪定对体外循环下心内直视手术术后肺损伤的保护作用  

Protective effect of dexmedetomidine on lung injury after cardiac surgery under cardiopulmonary bypass

作　　者：陈转侨[1] 吴立新[1] 刘瑾[1] 罗渭康[1] 廖小卒[1] 

机构地区：[1]中山市人民医院麻醉科,广东中山528403

出　　处：《临床肺科杂志》2015年第1期13-16,共4页Journal of Clinical Pulmonary Medicine

基　　金：广东省中山市医学科研基金(No 2013A020267)

摘　　要：目的 探讨右美托咪定对体外循环下心内直视手术患者术后肺损伤的保护作用。方法 收集我院60例心脏手术患者病例,随机分为两组,每组30例。观察组患者麻醉诱导前给予右美托咪定负荷量1.0μg/kg,维持量0.7μg/（kg·h）至手术结束,对照组不做处理。对两组患者T0（给药前）、T1（转流前）、T2（停机后1 h）、T3（停机后4 h）、T4（停机后24 h）的TNF-α、IL-1β、IL-6水平和肺泡动脉氧分压差（AaDO2）、氧合指数（OI）、呼吸指数（RI）进行对比分析。结果 两组中,与T0点比较,T1-T4点TNF-α、IL-1β、IL-6呈现先增大后减小的趋势,两组各点比较差异有统计学意义（P〈0.05）;而观察组各时间点TNF-α、IL-1β、IL-6水平显著性低于对照组（P〈0.05）。两组中,与T0点比较,T1-T3点AaDO2、RI均升高（P〈0.05）,OI指数降低（P〈0.05）;观察组各时间点AaDO2、OI、RI低于对照组（P〈0.05）。结论 右美托咪定能有效抑制体外循环下心内直视手术患者术后炎症反应,促进修复肺损伤。Objective To research the protective effect of dexmedetomidine on lung injury after cardiac surgery under cardiopulmonary bypass. Methods 60 cases of cardiac surgery patients in our hospital were selected and randomly divided into two groups, each 30 cases. The observation group was given 0.7 μg/（kgoh） dexmedetomidine after anesthesia at the end of surgery, and the control group was not given any treatment. The levels of TNF-α, IL-1β and IL-6 and alveolar-arterial oxygen difference （ AaDO2 ）, oxygenation index （ OI）, respiratory index （RI） of the two groups were detected at T0 （ before administration）, T1 （ before CPB）, T2 （ after the shutdown 1 h）, Ts （ after stopping 4h） , and T4 （ after stopping 24h）. Results The levels of TNF-α, IL-1β and IL-6 of the two groups at T1 - T4 point showed a decreasing trend after the first increases, and the difference was statistically significant at each point （ P 〈 0. 05 ）. The levels of TNF-α, IL-1β and IL-6 were significantly lower in the observation group than in the control group （ P 〈 0. 05 ）. The value of AaDO： and RI of the two groups at T1 - T3 showed a increasing trend （ P 〈 0.05 ）, and the value of OI of the two groups at T1- T3 showed a decreasing trend. The values of AaDO2, OI and RI were significantly lower in the observation group than in the control group （ P 〈 0. 05 ）. Conclusion Dexmedetomidine can effectively inhibit inflammation and repair lung injury of heart surgery patients with cardiopulmonary bypass.

关 键 词：右美托咪定 炎症反应 肺损伤 

分 类 号：R614[医药卫生—麻醉学]