右美托咪定对成年人食管下括约肌功能的影响  

Effect of dexmedetomidine on the lower esophageal sphincter in adults

作　　者：鲁应军[1] 陈章玲[2] 朱涛[1] 纪健[1] 徐凯[3] LU Yingjun, CHEN Zhangling, ZHU Tao , JI Jian , XU Kai(Department of Anesthesiology , Songjiang Branch of the First People ＇ s Hospital , Shanghai Jiaotong University, Shanghai 201600, China)

机构地区：[1]上海交通大学附属第一人民医院松江分院麻醉科,上海201600 [2]上海交通大学附属第一人民医院松江分院眼科,上海201600 [3]上海交通大学附属第一人民医院分院消化内科,上海201600

出　　处：《上海医学》2018年第7期428-430,共3页Shanghai Medical Journal

摘　　要：目的探讨右美托咪定对食管下括约肌(LES)功能的影响。方法选择2014年6月—2015年10月在上海交通大学附属第一人民医院松江分院行胃镜检查证实无器质性病变的成年志愿者,年龄20～59岁。按照随机数字表法分为右美托咪定0.5μg/kg组、右美托咪定0.8μg/kg组、右美托咪定1.0μg/kg组和对照组,前3组分别将右美托咪定0.5、0.8和1.0μg/kg用0.9%氯化钠溶液稀释至30mL,在15min内经静脉泵注射完成,对照组在15min内经静脉泵注射0.9%氯化钠溶液30mL。所有受试者均在未给药前和给药后15min应用Medical Measurement Systems(MMS)胃肠动力监测系统测定胃内压(GP)、LES压力(LESP)和LES长度(LESL),LESP与GP之差即屏障压(BrP)。结果符合纳入标准的受试者81名,男39名、女42名。4组受试者间性别构成、年龄、身高、体重的差异均无统计学意义(P值均>0.05)。在泵注药物之前,4组间GP、LESP、BrP和LESL的差异均无统计学意义(P值均>0.05)。在泵注药物之后,右美托咪定0.5μg/kg组、右美托咪定0.8μg/kg组和对照组的GP、LESP、BrP和LESL与同组泵注药物前的差异均无统计学意义(P值均>0.05);右美托咪定1.0μg/kg组的GP和LESL与同组泵注药物前的差异均无统计学意义(P值均>0.05),但LESP和BrP均显著低于同组泵注药物前(P值均<0.05)。结论临床应用不超过1.0μg/kg剂量的右美托咪定对正常成年人LES的功能无影响。Objective To evaluate the effect of dexmedetomidine on the function of lower esophageal sphincter （LES）. Methods Healthy adult volunteers, aged 20-5g years otd, confirmed by gastroscopy in the Songjiang Branch of the First Peeple＇ s Hospital Affiliated to Shanghai Jiaotong University from June 2014 to October 2015, were enrolled in this study and randomly divided into four groups. Dexrnedetornidine （0.5, 0.8 and 1.0 μg/kg diluted to 30 mL with 0.9% sodium chloride solution） and 30 mL 0.9% sodium chloride solution （control group） were injected by intravenous pump within 15 min in each group, respectively. The gastric pressure （GP）, LES pressure （LESP） and LES length （LESL） were measured by the Medical Measurement Systems （MMS） gastrointestinal monitoring system at 15 min before and after the drug delivery. The difference between LESP and GP was the barrier pressure （BrP）. Results There were 81 subjects who met inclusion criteria, including 39 males and 42 females. There was no significant difference in sex, age, height or weight between the 4 groups （all P〉0. 05）. No significant difference was found in the GP, LESP, BrP or LESL before injection between the 4 groups （all P〉0.05）. As compared with those before injection, the levels of GP, LESP, BrP and LESL were not significantly changed in the dexmedetomidine 0.5 μg/kg group, dexmedetomidine 0.8 μg/kg group and control group after injection （all P〉0. 05）, and the levels of GP and LESL were not significantly changed in the dexmedetomidine 1.0 μg/kg group after injection （both P〉0.05）. However, both LESP and BrP after injection were significantly lower than those before injection in the dexmedetomidine 1.0 μg/kg group （both P〈0. 05）. Conclusion Conventional dose of dexmedetomidine （〈1 μg/kg） has no adverse effect on the function of lower esophageal sphincter in normal adults. （Shanghai Med J, 2018, 41= 428-430）

关 键 词：右美托咪啶 食管括约肌 下段 麻醉 

分 类 号：R614[医药卫生—麻醉学]