右美托咪定对脓毒症患者围术期血浆中细胞因子的影响  

Influence of dexmedetomidine on plasma cytokines during perioperative period in patients with sepsis

作　　者：钱玲珠 张赛男[2] 蒋永泼 QIAN Lingzhu;ZHANG Sainan;JIANG Yongpo(ICU, Taizhou Hospital in Zhejiang Province, Taizhou 318000, China;Department of Anesthesiology, Taizhou Hospital in Zhejiang Province, Taizhou 318000, China)

机构地区：[1]浙江省台州医院重症医学科,浙江台州318000 [2]浙江省台州医院麻醉科,浙江台州318000

出　　处：《中国现代医生》2018年第12期110-112,共3页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2017KY706)

摘　　要：目的探讨右美托咪定对脓毒症患者围术期血浆中细胞因子的影响。方法选取2014年8月~2016年1月本院所收治的脓毒症患者90例作为研究对象,将所有患者随机分为对照组和研究组各45例,对照组患者在实施麻醉时静脉注入生理盐水,研究组患者在麻醉过程中静脉注入与对照组等量的右美托咪定,使用酶联免疫吸附试验(ELISA)对血清中的白细胞介素-6(IL-6)、白细胞介素-10(IL-10)以及肿瘤坏死因子-α(TNF-α)的水平进行检测。结果研究组患者血清中的IL-10显著高于对照组(P<0.05),且研究组患者血清中的IL-6与TNF-α明显低于对照组(P<0.05);研究组患者的治疗有效率为86.7%明显好于对照组的73.3%(P<0.05)。结论采用右美托咪定治疗脓毒症能够有效调整患者围术期血浆中细胞因子的表达,使患者围术期血清IL-10水平升高,血清IL-6和TNF-α降低,有益于改善脓毒症患者预后,患者术后恢复情况明显好转,效果理想,临床上值得进一步推广应用。Objective To investigate the influence of dexmedetomidine （DEX） on plasma cytokines during perioperative period in patients with sepsis. Methods 90 patients with sepsis in our hospital from August, 2014 to January, 2017 were selected and randomized into control group and study group with 45 patients in each. Patients in control group were given normal saline by intravenous injection when anesthesia administration. Patients in study group were given same dose of DEX by intravenous injection when anesthesia administration. The levels of serum interleukin-10 （IL-10）, interleukin-6 （IL-6） and tumor necrosis factor-α（TNF-α） were assessed by enzyme-linked immunosorbent assay（ELISA）. Results The level of serum IL-10 in study group was significantly higher than that in control group（P〈0.05）. The levels of serum IL-6 and TNF-α were statistically lower than those in control group（P〈0.05）. The effective rate of treatment in study group （86.7%） was significantly higher than that in control group （73.3%） （P〈0.05）. Conclusion The treatment of DEX in patients with sepsis could regulate the expression of plasma cytokines during perioperative period by increasing the level of serum IL-10 and decreasing the levels of IL-6 and TNF-α during perioperative period. It could improve the prognosis of patients with sepsis and patients＇ recovery after operation. The clinical effectiveness was satisfactory and it would be worth promotion in clinic.

关 键 词：右美托咪定 脓毒症 白细胞介素-10 白细胞介素-6 肿瘤坏死因子-Α 

分 类 号：R614[医药卫生—麻醉学] R459.7[医药卫生—外科学]