盐酸右美托咪定对颅内手术患者肾上腺素、去甲肾上腺素和S100β蛋白质浓度的影响  

Effect of dexmedetomidine on epinephrine,norepinephrine and S100 protein in patients undergoing intracranial tumor surgery

作　　者：刘晓云[1] 刘艳丽[1] 刘晓[1] 张岚[1] 张树立[1] 徐凯智[1] 

机构地区：[1]华北理工大学附属唐山工人医院麻醉科,河北唐山063000

出　　处：《河北联合大学学报（医学版）》2015年第4期25-28,共4页Journal of North China Coal Medical College

摘　　要：①目的探讨盐酸右美托咪定对颅内肿瘤手术患者肾上腺素（E）、去甲肾上腺素（NE）和脑损伤标志物（S100β）蛋白浓度的影响。②方法随机选择颅内肿瘤手术患者30例。随机分为右美托咪定组（A组）和对照组（B组）两组,每组15例。A组在麻醉诱导前15min内静脉泵入右美托咪定1.0μg/kg,并以0.5μg/（kg·h）维持,B组患者泵入等体积的生理盐水。其他麻醉用药及剂量两组均相同。分别于全麻诱导前（T0）、手术开始（T1）、切开硬脑膜即刻（T2）、术毕（T3）、手术后1h（T4）5个时间点同步采集颈内静脉球部静脉血和桡动脉血进行血气分析,并检测静脉血E、NE、S100β蛋白的浓度。③结果 B组患者E及NE在T1～T4浓度升高,与T0相比差异有统计学意义（P〈0.05）;A组的E及NE水平在T1～T4时间点低于B组,差异有统计学意义（P〈0.05）。A组患者E及NE浓度在T2～T4时间点均低于T0,差异有统计学意义（P〈0.05）;两组患者的血浆S100β蛋白在T1～T4时间点均显著升高,与T0相比差异有统计学意义（P〈0.05）;A组患者S100β蛋白在T1～T4时间点低于B组,差异有统计学意义（P〈0.05或P〈0.01）。④结论右美托咪定通过降低颅内手术患者血浆E、NE和血浆S100β蛋白浓度,起到脑保护作用。Objective To study effect of dexmedetomidine on epinephrine and norepinephrine and damage markers（ S100） protein in patients undergoing intracranial tumor surgery. Methods 30 patients,undergoing intracranial tumor surgey were randomly divided into two groups： the dexmedetomidine group（ group A） and the control group（ group B）,15 cases each group. Patients in group A,dexmedetomidine 1. 0μg / kg were injected within 15 minutes before anesthesia induction,and continuous intravenous injection 0. 5μg / kg·h,patients in group B was injected equal volume of physiological saline. Other narcotic drugs and dosage were consistent with the control group. Blood samples were obtained at before general anesthesia（ T0）,skin incision（ T1）,open dural immediately（ T2）,end of surgery（ T3）,1h after of the surgery（ T4） synchronization acquisition of internal jugular vein ball and radial artery blood gas analysis respectively. Using ELISA method to detect venous blood E,NE,S100β protein. Results E and NE concentration in group B increased at T1～ T4,compared with the T0,the difference was statistically significant（ P〈0. 05）; E and NE concentration at T1～ T4 was lower than that of group C,there were significant difference between two group（ P 0. 05）. E and NE concentration at T2～ T4 are lower than T0 in group B. the difference was statistically significant（ P 0. 05）; Compared with the Tm0,plasma S100 β protein at Tm1 ～ T4 were significantly increased,the difference was statistically significant（ P 0. 05）; S100β protein at T1～ T4 in group A were significantly lower than that of group B,there were significant difference between two group（ P 0. 05 or P 0. 01）. Conclusion Dexmedetomidine has a certain brain protection in the patients undergoing intracranial tumor surgey by reducing the serum E,NE and S100β protein.

关 键 词：颅内手术 麻醉 盐酸右美托咪定 肾上腺素 去甲肾上腺素 S100Β蛋白 

分 类 号：R614[医药卫生—麻醉学]