右美托咪定和磷酸肌酸对重度烧伤患者心肌保护作用的比较研究  

Comparative analysis of protective effects of Dexmedetomidine and Phosphocreatine on myocardial injury in severe burn patients

作　　者：彭晓恩 张兆龙[1] 董慧咏[1] 王宇[2] PENG Xiao-en;ZHANG Zhao-long;DONG Hui-yong;WANG Yu(Department of Anesthesiology, the First Hospital of Shijiazhuang, Shijiazhuang 050011, China;Department of Internal Medicine-Cardiovascular, the First Hospital of Shijiazhuang, Shijiazhuang 050011, China)

机构地区：[1]石家庄市第一医院麻醉科,石家庄050011 [2]石家庄市第一医院心血管内科,石家庄050011

出　　处：《中国医学前沿杂志（电子版）》2018年第4期67-71,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：河北省科技计划项目(152777229)

摘　　要：目的对比分析右美托咪定和磷酸肌酸对重度烧伤患者心肌的保护作用。方法选取2015年8月至2017年8月于本院行手术治疗的105例重度烧伤患者为研究对象,采用随机数表法将其分为右美托咪定组、磷酸肌酸组及生理盐水组,每组各35例。右美托咪定组患者给予盐酸右美托咪定注射液,磷酸肌酸组患者给予注射用磷酸肌酸钠,生理盐水组患者给予0.9%氯化钠注射液。比较三组患者的肌酸激酶同工酶-MB(creatine kinase isozyme-MB,CK-MB)、心肌肌钙蛋白Ⅰ(cardiac troponin Ⅰ,cTnI)、乳酸脱氢酶(lactate dehydrogenase,LDH)、超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondialdehyde,MDA)水平,同时记录三组患者术中心血管不良反应发生情况。结果生理盐水组患者术毕及术后12、24、36小时CK-MB、cTnI、LDH水平均明显高于麻醉诱导前(P<0.05),右美托咪定组和磷酸肌酸组患者术毕及术后12、24、36小时CK-MB、cTnI、LDH水平均明显低于麻醉诱导前(P<0.05)。磷酸肌酸组患者术毕及术后12、24、36小时CK-MB、cTnI、LDH水平均明显低于生理盐水组(P<0.05);右美托咪定组患者术毕及术后12、24、36小时CKMB、cTnI、LDH水平均明显低于生理盐水组和磷酸肌酸组(P<0.05)。生理盐水组患者术后36小时SOD水平明显低于术前,MDA水平明显高于术前(P<0.05);右美托咪定组和磷酸肌酸组患者术后36小时SOD水平均明显高于术前(P<0.05),MDA水平均明显低于术前(P<0.05);磷酸肌酸组患者术后36小时SOD水平明显高于生理盐水组(P<0.05),MDA水平明显低于生理盐水组(P<0.05);右美托咪定组患者术后36小时SOD水平明显高于生理盐水组和磷酸肌酸组(P<0.05),MDA水平明显低于生理盐水组和磷酸肌酸组(P<0.05)。三组患者术中均未出现心血管不良反应。结论与磷酸肌酸相比,右美托咪定减轻重度烧伤患者心肌损伤的效果更为显著,可有效降低血清CK-MB、cTnI、LDH水平,明显Objective To investigate the protective effects of Dexmedetomidine and Phosphocreatine on myocardial injury in severe burn patients. Method A total of 105 patients with severe burn underwent surgical treatment in the First Hospital of Shijiazhuang from August 2015 to August 2017 were selected as the study subjects and divided into Dex group（Dexmedetomidine）, PCr group（Phosphocreatine）, and NS group（normal saline） by random number table method, each with 35 cases. Dex group patients were given Dexmedetomidine hydrochloride injection, PCr group patients were given Creatine phosphate sodium for injection, NS group patients wer given 0.9% Sodium chloride injection. The creatine kinase-MB（CK-MB）, cardiac troponin Ⅰ（cTnI）, lactate dehydrogenase（LDH）, superoxide dismutase（SOD）, malondialdehyde（MDA） of the three groups were compared, then the incidence of central vascular adverse reactions was recorded. Result The concentration of CK-MB, cTnI and LDH at 0, 12, 24 and 36 hours after operation in NS group were significantly higher than those before anesthesia induction（P〈0.05）, and the concentration of CKMB, cTnI and LDH at 0, 12, 24 and 36 hours after operation in Dex group and PCr group were significantly lower than those before anesthesia induction（P〈0.05）. The concentration of CK-MB, cTnI and LDH at 0, 12, 24 and 36 hours after operation in PCr group were significantly lower than those in NS group（P〈0.05）. The concentration of CK-MB, cTnI and LDH at 0, 12, 24 and 36 hours after operation in Dex group were significantly lower than those in PCr group and NS group（P〈0.05）. The level of SOD at 36 hours after operation in NS group was significantly lower than that before operation（P〈0.05）, and the level of MDA was significantly higher than that before operation（P〈0.05）, and the level of SOD at 36 hours after operation in Dex group and PCr group were significantly higher than that before operation（P〈0.05）, and the level of MDA were significantly lowe

关 键 词：右美托咪定 磷酸肌酸 重度烧伤 心肌损伤 

分 类 号：R614[医药卫生—麻醉学]