右美托咪定对肝门阻断手术血浆SDF-1表达水平的影响  

Effect of dexmedetomidine on plasma SDF-1 levels in hepatic portal occlusion operation

作　　者：杨贞[1] 甯交琳[1] 顾健腾[1] 易斌[1] 鲁开智[1] Yang Zhen Ning Jiaolin Gu Jianteng Yi Bing Lu Kaizhi(Department of Anesthesiology, Southwest Hospital, Third Military Medical University, Chongqing 400038, Chin)

机构地区：[1]第三军医大学西南医院麻醉科,重庆400038

出　　处：《重庆医学》2017年第13期1765-1767,共3页Chongqing medicine

基　　金：国家自然科学基金资助项目(81270510)

摘　　要：目的观察肝门阻断患者围术期血浆SDF-1表达水平的变化及右美托咪定对其的影响。方法将50例择期行肝癌切除术的患者[年龄42~71岁,体质量指数(BMI)18.5~26.0kg/m^2,ASA分级Ⅱ~Ⅲ级]分为对照组及右美托咪定组,每组各25例。右美托咪定组在麻醉诱导前15min开始持续泵注右美托咪定1μg/kg,诱导后泵注速度改为0.4μg·kg^(-1)·h^(-1),直至手术结束前15min;对照组以同样的方法静脉持续输注相同容量的0.9%氯化钠注射液。两组患者分别于术前1h(T0)、术后1h(T1)、1d(T2)、3d(T3)采集外周静脉血,采用酶联免疫吸附试验(ELISA)检测各时间点血浆中SDF-1的表达水平。结果两组患者术中肝脏切除范围、出血量、第一肝门血管阻断时间、麻醉时间及术前血浆SDF-1水平比较,差异均无统计学意义(P>0.05)。与术前相比,术后T1、T2、T3时间点血浆SDF-1均明显升高(P<0.05)。与对照组相比,右美托咪定组T1、T2、T3时间点SDF-1表达水平低于对照组(P<0.05)。结论 SDF-1在肝门阻断患者围术期表达明显增高,术中持续给予右美托咪定能够显著降低其表达水平,从而在一定程度上抑制炎症细胞的趋化聚集。Objective To observe the effect of dexmedetomidine on plasma SDF-1level in in hepatic portal occlusion operation.Methods Fifty patients with live cancer undergoing elective partial hepatectomy were selected,no gender limitation,aged 42to71,body mass index（BMI）18.5 ~ 26.0kg/m^2,ASA gradeⅡ orⅢ.The patients were randomly divided into 2groups（n=25）：control group and dexmedetomidine group.The dexmedetomidine group was performed the pump injection of dexmedetomidine1μg/kg at 15 min before induction of anesthesia.After induction the rate was changed to 0.4μg·kg-1·h-1 until 15 min before the end of operation;the control group adopted the same method for conducting continuous intravenous infusion of the same capacity of 0.9% sodium chloride.The peripheral venous blood was collected in 2groups at preoperative 1h（T0）,postoperative 1h（T1）,postoperative 1d（T2）,postoperative 3d（T3）.The plasma SDF-1level was detected by using enzyme-linked immunosorbent assay（ELISA）.Results There was no statistically significant difference in liver resection range,blood loss,first porta hepatis vessel occlusion time,anesthesia time and plasma SDF-1level before surgery between the two groups（P〈0.05）.Compared with pre-operation,plasma SDF-1level at T1,T2,T3 time point was significantly increased（P〈0.05）.The plasma SDF-1level at T1,T2,T3 time point in the dexmedetomidine group was lower than that in the control group（P〈0.05）.Conclusion SDF-1expression is significantly increased during perioperative period in the patients with hepatic portal occlusion operation,and intraoperative continuous dexmedetomidine can significantly reduce the SDF-1level,which inhibits the chemotaxis and accumulation of inflammatory cells to some extent.

关 键 词：右美托咪定 肝门阻断术 基质细胞衍生因子-1 围术期 

分 类 号：R614[医药卫生—麻醉学]