右美托咪定对宫颈癌根治术患者HMGB1与Syndecan1水平影响及抗炎机制  

Effects of Dexmedetomidine on HMGB1 and Syndecan1 Levels in Patients Undergoing Radical Cervical Cancer Resection and Its Anti-inflammatory Mechanism

作　　者：代景伟[1] 陈振毅[1] 冯宇峰[1] 林梁[1] DAI Jingwei;CHEN Zhenyi;FENG Yufeng;LIN Liang(Department of Anesthesiology,The First Affiliated Hospital of Xiamen University,Xiamen Fujian 361022,China)

机构地区：[1]厦门大学附属第一医院麻醉科

出　　处：《中国卫生标准管理》2019年第19期112-115,共4页China Health Standard Management

摘　　要：目的观察丙泊酚、瑞芬太尼、右美托咪啶全凭静脉麻醉对宫颈癌根治术患者高迁移率族蛋白B1(HMGB1)与多配体蛋白聚糖-1(Syndecanl)水平影响及抗炎作用。方法选取2014年7月-2017年7月,在本院行宫颈癌根治术患者120例,均在TIVA下择期行宫颈癌根治术,随机分为两组,观察组(60例)行丙泊酚、瑞芬太尼、右美托咪啶TIVA,对照组(60例)行丙泊酚、瑞芬太尼、等剂量生理盐水TIVA,观察患者手术时间、尿量、输液量和术前、术后3、6、12、24小时患者体温、心率、血清白细胞计数、白细胞介素6(IL-6)、高迁移率蛋白C(HMGB1)、肿瘤坏死因子α(TNF-α)及Syndecan1含量变化情况。结果两组患者手术时间、尿量及输液量对比差异无统计学意义(P>0.05);观察组患者术后3、6小时心率及体温低于对照组,术后24小时血清白细胞计数低于对照组,差异均有统计学意义(P<0.05);观察组患者术后24小时血清HMGB1低于对照组,术后3、6小时血清IL-6含量低于对照组,差异均有统计学意义(P<0.05)。结论丙泊酚、瑞芬太尼、右美托咪啶TIVA用于宫颈癌根治术可降低患者血清炎性因子含量,减轻机体应激反应程度。Objective To investigate the effects of total intravenous anesthesia(TIVA)with propofol, remifentanil and dexmedetomidine on the levels of HMGB1 and Syndecan1 in patients with cervical cancer and the anti-inflammatory mechanism. Methods From July 2014 to July 2017, 120 cases of cervical cancer diagnosed in our hospital were selected for this study. Patients underwent radical gastrectomy for cervical cancer under TIVA. All patients were randomly divided into two groups. The patients in the observation group(60 cases) received TIVA with propofol combined, remifentanil and dexmedetomidine. The control group(60 cases) received TIVA with propofol, remifentanil and equal dose normal saline. The operation time, urine output and infusion volume, the changes of body temperature, heart rate, serum leukocyte count, IL-6, HMGB1, TNF-α and Syndecan1 before operation and in 3,6,12,24 hours after operation were observed. Results There was no significant difference in operative time, urine output and transfusion between the two groups(P > 0.05). The heart rate and body temperature of the patients in the observation group were lower than those in the control group in 3 and 6 hours after operation, and the serum leukocyte count was lower than the control group at 24 hours after operation, the differences were statistically significant(P < 0.05). The level of serum HMGB1 in the observation group was lower than that in the control group at 24 hours after operation, and the level of serum IL-6 in the observation group was lower than that in the control group at 3 and 6 hours after operation,the differences were statistically significant(P < 0.05). Conclusion TIVA with Propofol, remifentanil and dexmedetomidine can decrease serum inflammatory cytokines and relieve stress response in patients undergoing radical operation of cervical cancer.

关 键 词：丙泊酚 瑞芬太尼 右美托咪啶 全凭静脉麻醉 宫颈癌根治术 炎性因子 

分 类 号：R614[医药卫生—麻醉学]