右美托咪啶注射液对脑外介入治疗患者脑代谢影响及脑损伤的保护作用  

Protective efficacy of dexmedetomidine injection on brain injury of patients with brain surgery undergoing intervention and study on its effect of cerebral metabolic

作　　者：袁军[1] 李继勇[1] 吴昱[1] 张力[1] 卢凡[1] 邓方方[1] 

机构地区：[1]武汉市第一医院麻醉科,武汉430022

出　　处：《中国临床药理学杂志》2016年第20期1834-1837,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的研究右美托咪定对脑外介入治疗患者血流动力学的影响及脑损伤的保护作用。方法将进行介入治疗的90例脑外疾病患者随机分为2组,每组45例。试验组麻醉前10 min静脉泵注右美托咪啶0.6μg·kg^(-1),然后以0.4μg·kg^(-1)持续泵注。对照组以同样方式,泵注等量生理盐水。对2组患者诱导前(T0)、气管导管插管(T_1)、拔管即刻(T_2)、拔管后5 min(T_3)这4个时间点的平均动脉压(MAP)及心率(HR)进行观察。依据Fick公式计算2组不同时刻脑动静脉血氧含量差(AV-DO2)及脑氧摄取率(CO_2ER)并进行统计学分析。结果与T0点比较,在T_1~T_3点,2组MA和HR呈现出先增大后减小的波动趋势。在T_1、T_2、T_3各点,试验组MAP分别为(97.8±12.6),(90.6±10.7),(86.3±11.4)mm Hg,均显著低于对照组的(106.6±12.8),(98.6±11.9),(94.2±12.3)mm Hg,2组比较差异有统计学意义(P<0.05)。在T_1、T_2、T_3各点,试验组的HR分别为(89.7±9.4),(86.8±10.6),(84.1±11.8)次/分,均显著低于对照组的(96.8±9.8),(94.1±8.9),(90.6±9.7)次/分,2组比较差异有统计学意义(P<0.05)。在T_2、T_3时间点,试验组的AV-DO2分别为(44.1±12.8),(43.9±11.9)m L·L^(-1)、CO_2ER分别为(34.7±4.8)%,(31.4±3.9)%,显著性低于对照组(52.6±14.8),(58.7±15.6)m L·L^(-1)和(39.4±8.9)%,(36.8±7.8)%,2组比较差异有统计学意义(P<0.05)。在T_2、T_3时刻,试验组血清S100β蛋白水平分别为(1.52±0.35),(1.69±0.33)μg·L^(-1),均显著低于对照组的(1.98±0.41),(2.15±0.42)μg·L^(-1),差异均有统计学意义(均P<0.05)。结论右美托咪定可增加患者术中脑氧利用及脑氧合,对患者大脑起到保护作用。Objective To investigate the protective efficacy of dexmedetomidine on brain injury of patients with brain surgery undergoing intervention and study on its effect of cerebral metabolic.Methods Ninety cases of patients with brain surgery disease needed undergo intervention were selected and randomly divided into two groups with 45 cases in each group.Patients in treatment group were given 0.6 μg·kg^（-1）dexmedetomidine at 10 min before anesthesia.Then give 0.4 μg·kg^（-1）dexmedetomidine in anesthesia.Patients in control group were given equivalent saline infusion.To compare mean arterial pressure（MAP） and heart rate（HR） of two groups before induction（T0）,endotracheal tube intubation（T_1）,extubation（T_2）,and after extubation 5 min（T_3）.And according to Fick equation to calculate cerebral arteriovenous oxygen content difference（AV-DO2） and cerebral oxygen uptake rate（CO_2ER） of two groups at T_3,T4 were observed.Results Compared with T0 point,MAP and HR levels of two groups at T_1,T_2,T_3 point showed a decreasing trend after the first increases.At T_1,T_2,T_3 point,MAP level of treatment group with（97.8 ± 12.6）,（90.6 ±10.7）,（86.3 ± 11.4） mm Hg was decreased significantly than in control group with（106.6 ± 12.8）,（98.6 ± 11.9）,（94.2 ± 12.3） mm Hg（P 0.05）.HR level of treatment group with（89.7 ± 9.4）,（86.8 ± 10.6）,（84.1 ± 11.8）times·min^（-1）were significantly lower than the control group with（96.8 ± 9.8）,（94.1 ± 8.9）,（90.6 ± 9.7）times·min^（-1）（P 0.05）.At T_2,T_3 point,AV-DO2 of treatment group with（44.1 ± 12.8）,（43.9 ± 11.9）m L·L^（-1）were significantly lower than the control group with（52.6 ± 14.8）,（58.7 ± 15.6） m L·L^（-1）（P 0.05）.CO_2 ER of treatment group with（34.7 ± 4.8） %,（31.4 ± 3.9） % were significantly lower than the control group with（39.4 ± 8.9） %,（36.8 ± 7.8） %（P 0.05）.At T_2,T_3 point,the levels of S100β protein of treatment gro

关 键 词：脑外科疾病 介入治疗 右美托咪定 保护大脑 

分 类 号：R971.3[医药卫生—药品]