右美托咪定对高原心脏瓣膜置换患者的心肌保护机制  

Dexmedetomidine Protecting Myocardium During Cardiac Valve Replacement Surgery at High Plateau

作　　者：祁恒宁 QI Heng-ning(Qinghai Cardiovscular Hospita)

机构地区：[1]青海心脑血管病专科医院

出　　处：《中国高原医学与生物学杂志》2017年第4期285-288,共4页Journal of Chinese High Altitude Medicine & Biology

摘　　要：目的探讨右美托咪定对高原心脏瓣膜置换患者的心肌保护机制。方法将高原心脏瓣膜置换患者随机分为观察组(n=50)和对照组(n=50)。观察组在常规麻醉诱导前10 min内静脉注射右美托咪定(1.0μg·kg^(-1)),之后以0.5μg·(kg·h)^(-1)静脉输注至术毕。于T1、T2、T3、T4、T5时记录心型脂肪酸结合蛋白、肌酸激酶同工酶和肌钙蛋白Ⅰ水平。对照组除使用等量生理盐水外,余同。结果与对照组相比较,在T1-T5时间段,右美托咪定组的心率和平均动脉压的波动明显减少;在T2-T5时间段,右美托咪定组的心型脂肪酸结合蛋白、肌酸激酶同工酶和肌钙蛋白Ⅰ明显低于对照组(P<0.05)。结论对高原心脏瓣膜置换患者,右美托咪定可能通过减少术中血流动力学参数的波动发挥心肌保护作用。Objective To explore the myocardium protecting mechanism of Dexmedetomidine during cardiac valve replacement surgery at high plateau.Method 100 patients who taken cardiac valve replacement surgery were divided into dexmedetomidine group（ n = 50）and control group（ n = 50）randomly.Patients in dexmedetomidine group were intravenous injected with dexmedetomidine（ 1.0μg· kg^-1 ）for 10 minutes before anesthesia induction and fol- lowed by intravenous infusion of dexmedetomidine 0.5 μg· （kg· h）^-1.The level of heart fatty acid binding protein, creatine kinase isoenzyme（CK-MB） and cTnI were detected at the time of T1 ,T2,T3,T4 and TS.The same meas- ures were taken for control group except for intravenous infusion of normal saline. Results Compared with control, heart rate and mean arterial pressure fluctuation of dexmedetomidine group at the time of T1- T5 reduced obviously and the level of heart fatty acid binding protein, creatine kinase isoenzyme（CK-MB） and cTnI also decreased obvi- ously（ P〈0.05 ）.Conclusion Dexmedetomidine may protect myocardium during cardiac valve replacement surgery at high altitude by the way of stability hemodynamic parameters during operation.

关 键 词：心脏瓣膜置换术 右美托咪定 心肌 保护 

分 类 号：R318[医药卫生—生物医学工程]