右美托咪定对老年和青少年脑外伤患者S100蛋白及NSE水平影响的研究  

The study of dexmedetomidine to S100 protein and NSE protein levels about elderly and adolescent patients with brain injury

作　　者：姚健春[1] 

机构地区：[1]汕头大学医学院第一附属医院,广东汕头515041

出　　处：《泰山医学院学报》2016年第8期851-853,共3页Journal of Taishan Medical College

摘　　要：目的通过检测老年和青少年脑外伤患者围手术期NSE和S100蛋白浓度水平的变化,研究右美托咪定对脑组织的保护作用。方法选择2013年1月—2015年1月间,我科室收治疗的脑外伤且实施手术治疗的患者120例。其中60例为年龄12岁～18岁的青少年患者,60例为年龄大于50岁的老年患者。单盲法分别将青年组及老年组分为右美托咪定组（即实验组30例）和生理盐水组（即对照组30例）。实验组的患者麻醉诱导前10 min静脉滴注右美托咪定1.0μg/kg,对照组在诱导前10 min滴注0.9%浓度的生理盐水,实验组及对照组均静注咪达唑仑0.1 mg/kg,芬太尼3～5μg/kg,丙泊酚2 mg/kg,顺式阿曲库胺0.2 mg/kg。测量各组入室即刻（T1）、气管插管后即刻（T2）、插管后10 min（T3）、手术开始后1 h（T4）、术毕即刻（T5）5个时间点的血浆NSE和S100蛋白的浓度。结果老年及青少年脑外伤外患者的基础NSE和Sl00蛋白浓度无显著差异（P〉0.05）。不同测量时间点老年组及青少年组NSE和Sl00蛋白浓度实验组均低于对照组,且差异有显著性（P〈0.05）。各个时点老年实验组NSE和S100蛋白浓度低于青少年实验组,且差异有显著性（P〈0.05）。结论右美托咪定可以降低老年和青少年脑外伤患者术中S100蛋白和NSE的浓度,对脑组织有一定保护作用,且对老年患者的保护作用强于青少年组。Objective ： study the protective effect of dexmedetomidine on brain tissue by detecting the elderly and ado- lescent brain NSE and S100 protein levels, Methods： received the brain trauma treatment and surgery treatment of 120 cases from January 2013 --January 2015. 60 cases of adolescent patients aged 12 years to 18 years, 60 cases aged more than 50 years older patients, youth and elderly patients were divided into dexmedetomidine group （experimental group, n = 30） and normal saline group （n = 30） by single-blind. Patients in the experimental group dexmedetomidine 1.0 Ixg/kg 10rain before induction of anesthesia, the experimental group and the control group were intravenous midazolam 0. 1 mg/kg, fenta- nyl 3 -5μg/kg, propofol 2 mg/kg, cis atracurium amine 0. 2 mg/kg Measurement immediately burglary （T1）, immedi- ately after intubation （T2）, after intubation 10min （T3）, after the start of surgery 1 h （T4）, surgery immediately （35） plasma NSE and S100 protein concentration. Results： Basic NSE and S100 of the patientg brain trauma was no significant difference （ P 〉 0. 05 ）. Different measurement time point of the older group and youth group S100 and NSE protein concen- tration in the experimental group were lower than the control group. Each point NSE and S100 protein of elderly patients group concentration lower than the youth group, and the difference was significant （P 〈 0. 05）. Conclusion： dexmedetomidine can reduce the concentration of the elderly brain trauma surgery S100 and NSE protein, and the protective effect in elderly patients is stronger than the youth group.

关 键 词：脑外伤 右美托咪定 NSE S100蛋白 

分 类 号：R614[医药卫生—麻醉学]