右美托咪啶对活体亲属供肾者术后肾功能的影响  

Effect of dexmedetomidine on renal function of donors of living-related renal transplants after nephrectomy

作　　者：龚华渠 星丽娜 代雪梅 汪海洋 GONG Huaqu;XING Lina;DAI Xuemei;WANG Haiyang(Department of Anesthesiology, West Theater General Hospital, Chengdu 610083,China;Department of Obstetrics and Gynecology, Beijing Municipal Corps Hospital, Chinese People’s Armed Police Force, Beijing 100027, China)

机构地区：[1]西部战区总医院麻醉科,成都610083 [2]武警北京总队医院妇产科,100027

出　　处：《武警医学》2019年第7期588-590,595,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨右美托咪啶对活体亲属供肾者术后肾功能的影响。方法选择2015-01至2017-12择期亲属供肾术者40例,随机分为右美托咪啶组和对照组,各20例。右美托咪啶组供肾者麻醉诱导前10~15 min静脉泵入右美托咪啶1μg/kg,继以0. 5μg/(kg·h)维持,手术结束前30 min停药;对照组供肾者按右美托咪啶组静脉泵入等量的生理盐水。于麻醉诱导前(T1)、术毕即刻(T2)、术后24 h(T3)、术后48 h(T4)采血检测TNFα、IL-6和IL-10的浓度。监测术前、术后24 h及48 h血清尿素氮(BUN)及肌酐(Cr)浓度。结果右美托咪啶组较对照组术后24 h和48 h血清BUN[24 h,(6. 41±1. 23)mmol/L vs (9. 24±1. 25) mmol/L;48 h,(6. 62±1. 30) mmol/L vs (8. 41±2. 4) mmol/L]和Cr[24 h,(98. 2±4. 7)μmol/L vs(111. 4±5. 1)μmol/L;48 h,(104. 4±6. 2)μmol/L vs (119. 5±8. 2)μmol/L]明显降低(P <0. 05)。T2-T4时右美托咪啶组与对照组比较,血清TNF-α和IL-6浓度均明显降低,而IL-10的浓度明显增高(P <0. 05)。结论一定剂量的右美托咪啶对活体亲属供肾者手术后早期具有肾功能保护作用。Objective To study the effect of dexmedetomidine on renal function of donors of living-related renal transplants after nephrectomy.Methods Forty donors of living-related renal transplants were randomly divided into two groups: group A (n=20) and group B (n=20). 10-15 min before anesthesia induction, dexmedetomidine(1 μg/kg) was infused intravenously and 0.5 μg/(kg·h) was maintained 30 minutes before the end of the nephrectomy. An equal volume of normal saline instead of dexmedetomidin was given to group B. The concentrations of TNF-α, IL-6 and IL-10 were detected before anesthesia induction (T1), immediately after nephrectomy (T2), 24 hours(T3) and 48 hours(T4) after nephrectomy, respectively. Concentrations of serum urea nitrogen (BUN)[24 h,(6.41±1.23) mmol/L vs (9.24±1.25) mmol/L;48 h,(6.62±1.30) mmol/L vs (8.41±2.4) mmol/L]and creatinine (Cr)[24 h,(98.2±4.7)μmol/L vs (111.4±5.1)μmol/L;48 h,(104.4±6.2)μmol/L vs (119.5±8.2)μmol/L]were monitored before anesthesia induction, 24 and 48 hours after nephrectomy.Results Serum BUN and Cr in group A were significantly lower than those in group B at 24 and 48 hours after nephrectomy (P<0.05). The serum TNF-α and IL-6 concentrations in group A were significantly lower than those in group B at T2-T4,but the concentration of IL-10 was significantly increased (P<0.05).Conclusions Some dose of dexmedetomidine has protective effect on renal function after living-related renal transplants after nephrectomy in the early stage.

关 键 词：右美托咪啶 亲属供肾 肾移植 炎性介质 肾功能 肾保护 

分 类 号：R699.2[医药卫生—泌尿科学]