盐酸右美托咪定对全麻高浓度氧通气患者的肺保护作用  

Protective effects of dexmedetomidine on lung injury induced by high concentration oxygen during general anesthesia

作　　者：王英[1] 赵琦[1] 靳彦涛[1] 罗文文[1] 张岚[1] 胡斌[1] 徐凯智[1] 

机构地区：[1]华北理工大学附属唐山工人医院,河北唐山063000

出　　处：《河北联合大学学报（医学版）》2016年第3期192-195,共4页Journal of North China Coal Medical College

摘　　要：1目的观察应用盐酸右美托咪定(dexmedetomidine,DEX)时全麻高浓度氧通气患者血清超氧化物歧化酶(Superoxide Dismutase,SOD)、丙二醛(Malondialdehyde,MDA)、Clara细胞分泌蛋白(CC16)的变化,探讨其对高浓度氧所致急性肺损伤的影响。2方法择期全身麻醉下行胃肠恶性肿瘤根治术患者40例,按随机数字表法分成两组,每组各20例,即生理盐水对照组(对照组)和DEX组(观察组)。所有患者均采用静吸复合麻醉,通气氧浓度在95%以上,分别在麻醉诱导前(T_0)、手术开始后1小时(T_1)、机械通气结束(T_2)及机械通气结束后1小时(T_3)抽取外周静脉血检测SOD、MDA、CC16的水平。3结果两组患者血清SOD、MDA、CC16水平在T_0差异无统计学意义(P>0.05);与T_0比较,两组患者SOD活力随通气时间延长逐渐降低,MDA、CC16浓度有所升高,差异有统计学意义(P<0.05);观察组患者血清SOD、MDA、CC16在T_1、T_2、T_33个时间点的变化明显小于对照组(P<0.05)。4结论 DEX可减轻全麻时高浓度氧通气造成的急性肺损伤,对肺有一定保护作用。该机制可能与其可减轻氧化应激反应相关。Objective To investigate the protective effects of dexmedetomidine on lung injury induced by high concentration oxygen though the change of SOD,MDA,CC16 in patients during general anesthesia.Methods A total of forty patients undergoing radical operation of gastrointestinal malignant tumor were randomly divided into two groups（n =20）：control group and dexmedetomidine group（Observation group）.All patients underwent general anesthesia ventilated with high concentration oxygen,ventilation oxygen concentration is above 95%.Peripheral venous blood samples were drawn to detect the level of SOA,MDA and CC16 before induction of anesthesia（T_0）,1hour after operation（T_1）,at the end of ventilation（T_2）,1hour after the extubation（T_3）and 1hour after the end of ventilation（T_3）.Results The difference of the levels of SOD,MDA,CC 16 between the two groups was no statistically significant at T_0（P〈0.05）.Compared with the level at T_0,The activity of SOD decreased gradually while the MDA decreased significantly,The differences between the two groups were signifincant,and the change of control group was greater（P〈0.05）,Serum CC16 levels of control group were markedly elevated at T2,T3（P〈 0.05）,with less rise of group DEX（P 〈0.05）.Conclusion Dexmedetomidine shows protective effect on lung injury induced by high concentration oxygen,and the inhibition of oxidative stress reaction may be involved in the mechanism.

关 键 词：右美托咪定 氧化应激反应 肺损伤 CLARA细胞分泌蛋白 

分 类 号：R614.1[医药卫生—麻醉学]