右美托咪定对感染性休克患者肾损伤分子-1和炎症因子的影响  

Effects of dexmedetomidine on levels of kidney injury molecule-1 and inflammatory cytokines in patients with septic shock

作　　者：陈艳红[1,2] 孙莹杰[1] 张毅男[1] 张铁铮[1] 

机构地区：[1]沈阳军区总医院麻醉科,辽宁沈阳110016 [2]康平县人民医院麻醉科,辽宁沈阳110500

出　　处：《临床军医杂志》2015年第11期1147-1150,共4页Clinical Journal of Medical Officers

摘　　要：目的观察右美托咪定对感染性休克患者围手术期肾损伤分子-1以及炎症因子的影响。方法选择感染性休克患者30例随机分为右美托咪定组（Dex组）和对照组（N组）。Dex组于麻醉诱导前静脉泵注Dex负荷剂量1μg/kg,15 min泵注完,继以0.2μg/（kg·h）持续泵注至术毕;N组以同样方式输注生理盐水。两组分别于麻醉诱导前（T0）、手术结束时（T1）、术后24 h（T2）、48 h（T3）、72 h（T4）共5个时点采用血生化法检测血清Scr和BUN含量,采用酶联免疫法测定尿液Kim-1和血清白介素-1β（IL-1β）、THF-α的水平。结果 Dex组患者在T2、T3时点的血清BUN和Scr水平显著低于N组,差异有统计学意义（P〈0.05）;患者尿液Kim-1水平和血清IL-1β、TNF-α水平在T1~T3时点Dex组均显著低于N组,差异有统计学意义（P〈0.05）。结论右美托咪定可通过抑制感染性休克患者炎症反应,而改善其受损的肾功能,具有明显的肾保护作用。Objective To investigate the effects of dexmedetomidine （Dex） on levels of kidney injury molecule-1（Kim-1） and in-flammatory cytokines in the patients with septic shock. Methods Thirty patients with septic shock were randomly devided into Dex group （n=15） and control group （n=15）. The blood and urine samples were taken immediately before induction of anesthesia（T0）, at the end of surgery （ T1 ） ,24 hours （ T2 ） ,48 hours （ T3 ） ,72 hours （ T4 ） after surgery,five point for determining the levels of Scr, BUN and Kim-1,TNF-α,IL-1β by blood biochemical method and ELISA. Results Compared with control group,the levels of urine Kim-1,serum TNF-α and IL-1βof the patients in Dex group were significantly decreased at T1-T3 time points （P〈0. 05 ）. While,the levels of serum Scr and BUN of the patients in Dex group were significantly decreased at T2,T3 time points （P〈0. 05）. Conclusion Dex may effectively inhibit inflammation and improve the impaired renal function of the patients with septic shock.

关 键 词：右美托咪定 肾损伤分子-1 白介素-1Β 肿瘤坏死因子-Α 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]