盐酸右美托咪定对重度烧伤患者心肌的保护作用  

The protective effects of dexmedetomidine on myocardial injury of severely burned patients

作　　者：彭晓恩 王宇[2] 

机构地区：[1]河北省石家庄市第一医院麻醉科,050000 [2]河北省石家庄市第一医院心血管内科,050000

出　　处：《实用医学杂志》2017年第15期2562-2565,共4页The Journal of Practical Medicine

基　　金：河北省省级科技计划项目(编号:152777229)

摘　　要：目的:探讨盐酸右美托咪定对重度烧伤患者心肌的保护作用。方法:选取2014年5月至2016年5月收治的78例重度烧伤患者作为研究对象(该研究经医院医学伦理委员会批准,并跟患者家属交代并签字)根据其临床治疗特征将其分为对照组和观察组,每组39例,对照组患者予烧伤常规基础上加以咪唑安定镇静治疗,观察组在烧伤常规上加以盐酸右美托咪定镇静治疗,治疗结束后比较两组患者治疗前后反映心肌功能相关指标以及心率(HR)、平均动脉压(MAP)。结果:(1)两组患者治疗后其SOD、MDA、CK-MB、c Tn I及TNF-α较治疗前均明显降低,且观察组降低程度明显优于对照组,比较差异间均具有统计学意义(P<0.05);(2)两组患者治疗后在MAP及HR较治疗前均有明显变化,且观察组HR降低程度及MAP升高程度均明显优于对照组(P<0.05);结论:右美托咪定可改善重度烧伤患者其SOD活性,降低CK-MB、c Tn I及TNF-α等表达水平,对重度烧伤患者的心肌组织可起到一定的保护作用。Objective To investigate the protective effects of dexmedetomidine on myocardial injury of severe burn patients.Methods Seventy-eight cases of severe burn patients were enrolled in this study in our hospital from May 2014 to May 2016.According to the clinical characteristics of treatment,the patients were divided into the control group and the observation group,with 39 cases in each group.Patients in the control group were treated with midazolam sedation on the basis of conventional burns,and patients in the observation group were treated with dexmedetomidine combined with midazolam sedation.The myocardial function-related indicators,heart rate(HR)and mean arterial pressure(MAP)of patients were compared between the 2 groups after treatment.Results (1)The SOD,MDA,CK-MB,c Tn I and TNF-αof the two groups after treatment were significantly lower than those before treatment,and the degree of reduction in the observation group was significantly higher than that in the control group(P<0.05);(2)There were significant changes in MAP and HR before and after treatment in the both 2 groups.The decrease s of HR and the degree of MAP elevation in the observation group were significantly higher than those in the control group(P<0.05,respectively).Conclusions Dexmedetomidine can improve the SOD activity of patients with severe burns,and the decreased expressions of CK-MB,c Tn I and TNF-αcan reduce the degree of damage to myocardial tissue microstructure,and can protect the myocardium of patients with severe burns.

关 键 词：盐酸右美托咪定 重度烧伤 心肌损伤 保护作用 

分 类 号：R644[医药卫生—外科学]