右美托咪定用于中老年患者体外循环下心脏瓣膜置换手术中的心肌保护作用  

Myocardial protection effect of dexmedetomidine on middle and old aged patients undergoing heart valve replacement surgery under cardiopulmonary bypass

作　　者：刘德军[1] 杨国庆 何芸 LIU De-jun;YANG Guo-qing;HE Yun(the Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000;Shaanxi ProvincialCancer Hospital,Xi＇an 710061,China)

机构地区：[1]陕西中医药大学第二附属医院,陕西咸阳712000 [2]陕西省肿瘤医院,陕西西安710061

出　　处：《临床医学研究与实践》2018年第32期94-96,共3页Clinical Research and Practice

摘　　要：目的探讨右美托咪定用于中老年患者体外循环下心脏瓣膜置换手术中的心肌保护作用。方法选择我院54例采用体外循环下心脏瓣膜置换术的中老年患者,将其分为观察组(于麻醉诱导前给予右美托咪定泵注)和对照组(给予等剂量的生理盐水泵注),每组27例。对比两组患者不同时间心肌损伤标志物、心率(HR)和平均动脉压(MAP)。结果观察组T_1、T_2、T_3的心型脂肪酸结合蛋白(H-FABP)、肌酸激酶同工酶MB(CK-MB)、心肌肌钙蛋白I(cTnI)水平均显著低于对照组(P<0.05);观察组T_1、T_2、T_3的HR与MAP水平均显著低于对照组(P<0.05)。结论右美托咪定在减少中老年患者体外循环下心脏瓣膜置换术中的循环波动和心肌损伤方面具有一定价值。Objective To investigate the myocardial protection effect of dexmedetomidine on middle and old agedpatients undergoing heart valve replacement surgery under cardiopulmonary bypass. Methods A total of 54 middle and oldaged patients in our hospital undergoing heart valve replacement surgery under cardiopulmonary bypass were selected,which were divided into observation group （pump dexmedetomidine before induction of anesthesia） and control group （pumpwith an equal dose of saline）, with 27 cases in each group. Myocardial injury markers, heart rate （HR） and mean arterialpressure （MAP） at different times were compared between the two groups. Results At the time ofT1,T2 andT3, the heart-type fatty acid-binding protein （H-FABP）, creatine kinase MB （CK-MB） and cardiac troponinI （cTnI） in the observationgroup were significantly lower than those in the control group （P〈0.05）. At the time ofT1,T2 andT3, the levels of HR andMAP in the observation group were significantly lower than those in the control group （P 〈0.05）. ConclusionDexmedetomidine can reduce circulating fluctuations and myocardial damage of middle and old aged patients treated byheart valve replacement surgery under cardiopulmonary bypass.

关 键 词：右美托咪定 体外循环 心脏瓣膜置换术 心肌损伤 

分 类 号：R614[医药卫生—麻醉学]