右美托咪定对腰椎手术患者单核细胞-血小板黏附及单核细胞活化功能的影响  

Effects of Dexmedetomidine on monocyte-platelet adhesion and monocyte activation in patients undergoing lumbar spinal fusion

作　　者：苗亚飞 

机构地区：[1]河南科技大学临床医学院河南科技大学第一附属医院麻醉科,河南洛阳471003

出　　处：《中国民康医学》2017年第4期58-60,76,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:探讨右美托咪定对腰椎减压内固定术患者单核细胞-血小板黏附及单核细胞活化功能的影响。方法:择期全身麻醉下行腰椎减压内固定术患者40例,美国麻醉医师协会(ASA)分级Ⅰ~Ⅱ级,随机分成右美托咪定组和对照组,每组各20例。在麻醉诱导前10min,右美托咪定组患者给予右美托咪定0.5μg/kg负荷量,后以0.5μg/(kg·h)泵注维持直至手术结束前15 min;对照组患者给予等容量生理盐水。于术前基础状态(T_1)、手术开始30 min(T_2)、手术结束后60 min(T_3)、术后1 d(T_4)、术后3 d(T_5)和术后5 d(T_6)共6个时间点抽血检测两组患者的单核细胞-血小板黏附CD42a^+/CD14^+、单核细胞活化功能HLADR^+/CD14^+、白细胞(WBC)、血小板(PLT)、C反应蛋白(CRP)。结果:与对照组相比,右美托咪定组患者的CD42a^+/CD14^+在T_2、T_3、T_4时刻显著降低(P<0.01);HLADR^+/CD14^+在T_4、T_5时刻显著升高(P<0.01);CRP和WBC在T_2、T_3、T_4、T_5时刻明显降低(P<0.01或P<0.05)。结论:右美托咪定用于腰椎减压内固定术患者具有降低其炎症反应以及调节其免疫抑制的作用。Objective： To investigate effects of Dexmedetomidine on monocyte-platelet adhesion and monocyte activation in patients undergoing lumbar spinal decompression and internal fixation. Methods： Forty patients（ Ⅰ-Ⅱ） undergoing lumbar spinal decompression and internal fixation were randomly divided into two groups： Dexmedetomidine group and control group,20 cases in each group. A loading dose of Dexmedetomidine（ 0. 5 μg/kg） 10 min before the induction and a continuous dose of Dexmedetomidine（ 0. 5μg/kg·h） were injected intravenously until 15 min before the end of operation in Dexmedetomidine group,while the equal volume of normal saline was given in control group. The serum levels of CD42a＋/CD14＋,HLADR＋/CD14＋,White blood cell（ WBC）,Platelets（ PLT）,C-reaetive protein（ CRP） were measured in the patients at 10 min before the induction（ T1）,30 min（ T2） after the beginning of operation and 60 min（ T3）,1 d（ T4）,3 d（ T5）,5 d（ T6） after the end of operation. Results： Compared to control group,the use of Dexmedetomidine was associated with a significant decrease in CD42a＋/CD14＋at T2,T3,T4（ P〈0. 01） and an obvious increase in HLADR＋/CD14＋at T4 and T5（ P〈0. 01） in Dexmedetomidine group. Compared to control group,at T2,T3,T4 and T5,CRP and WBC decreased obviously（ P〈0. 01 or P〈0. 05） in Dexmedetomidine group. Conclusions： Dexmedetomidine can inhibit the inflammatory response and reduce the immunosuppressive in the patients undergoing lumbar spinal decompression and internal fixation.

关 键 词：右美托咪定 单核细胞-血小板黏附 单核细胞活化 腰椎手术 

分 类 号：R614[医药卫生—麻醉学] R681.5[医药卫生—外科学]