不同剂量右美托咪定用于急性冠状动脉综合征PCI介入效果分析  

Clinical effect of different doses of dexmedetomidine on the PCI in patients with acute coronary syndrome

作　　者：李玉忠[1] 吴霭青 

机构地区：[1]广东省惠州市第三人民医院麻醉科,516002

出　　处：《蚌埠医学院学报》2016年第5期616-618,共3页Journal of Bengbu Medical College

摘　　要：目的：探讨不同剂量右美托咪定应用于急性冠状动脉（冠脉）综合征经皮冠脉介入术（PCI）的效果。方法：将接受PCI治疗的急性冠脉综合征患者80例随机分为低剂量组和高剂量组,各40例。低剂量组给予0.3μg/kg的右美托咪定进行镇静诱导,高剂量组给予0.6μg/kg的右美托咪定进行镇静诱导。比较2组患者围手术期心率、血压、术后应激指标和不良反应发生率。结果：高剂量组患者手术开始后T1-T5各时段的收缩压、舒张压及心率均低于低剂量组（P〈0.05-P〈0.01）。高剂量组患者手术后2 d心肌肌钙蛋白I、肌酸激酶、血浆脑钠肽、超敏C反应蛋白、白细胞介素-6和肿瘤坏死因子-α水平均显著低于低剂量组（P〈0.01）。2组患者不良反应发生率差异无统计学意义（P〉0.05）。结论：急性冠脉综合征PCI介入中使用0.6μg/kg右美托咪定进行镇静效果更优,术后应激反应更低,具有临床应用价值。Objective：To compare the clinical effects of different doses of dexmedetomidine on the percutaneous coronary intervention （ PCI） in patients with acute coronary syndrome. Methods：A total of 80 acute coronary syndrome patients treated with PCI were randomly divided into the high dose group and low dose group（40 cases each group）. The low dose group and high dose group were sedated with 0. 3 μg/kg and 0. 6 μg/kg of dexmedetomidine,respectively. The perioperative heart rate,blood pressure,postoperative stress index and adverse reaction between two groups were compared. Results：The systolic blood pressure,diastolic blood pressure and heart rate in high dose group were significantly lower than those in low dose group at T1 to T5 after the start of operation（ P〈0. 05 to P〈0. 01）. The levels of cTnI,CK-MB,BNP,hs-CRP,IL-6 and TNF-α in high dose group were significantly lower than those in low dose group after 2 days of operation（P〈0. 01）. The difference of the adverse reaction in two groups was not statistically significant （P〉0. 05）. Conclusions：The application of 0. 6 μg/kg of dexmedetomidine in acute coronary syndrome patients treated with PCI has good sedation effects and low stress response,which is worthy of clinical application.

关 键 词：冠状动脉疾病 经皮冠状动脉介入术 右美托咪定 剂量 

分 类 号：R543.3[医药卫生—心血管疾病]