右美托咪定辅助血管内介入栓塞术对颅内动脉瘤患者血清MMP-9 NSE及S100β水平的影响  

Effect of dexmedetomidine on the levels of MMP-9,NSE and S100β in patients with intracranial aneurysm

作　　者：李建军[1] 徐文中[1] 郭志波 丁健[1] 陈洁[1] 张淑玲 LI Jianjun;XU Wenzhong;GUO Zhibo;DING Jian;CHEN Jie;ZHANG Shuling(Department of Neurosurgery,the Second Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China;Department of Neurology,Zhengzhou Yihe Hospital,Zhengzhou 451000,China)

机构地区：[1]河南科技大学第二附属医院神经外科,河南洛阳471000 [2]郑州颐和医院神经科,河南郑州451000

出　　处：《中国实用神经疾病杂志》2019年第19期2160-2166,共7页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关计划联合共建项目(编号:2018020821)

摘　　要：目的探讨右美托咪定辅助血管内介入栓塞术对颅内动脉瘤患者血清基质金属蛋白酶-9(MMP-9)、神经元特异性烯醇化酶(NSE)及S100β水平的影响。方法选取2014-06-2016-06河南科技大学第二附属医院收治的64例颅内动脉瘤患者,依据建档顺序分为2组各32例。2组均行血管内介入栓塞术,研究组采用右美托咪定,对照组采用0.9%氯化钠注射液。对比不同时间段[麻醉前(T1)、麻醉后(T2)、手术开始时(T3)、术后6 h(T4)]2组血流动力学指标[心率(HR)、平均动脉压(MAP)]及血清MMP-9、NSE、S100β水平,统计不良反应发生率。结果 T1时期2组HR、MAP水平比较,差异无统计学意义(P>0.05),T2、T3、T4时期2组HR、MAP水平均有所变化,但研究组HR、MAP变化幅度小于对照组,差异有统计学意义(P<0.05);T1时期2组MMP-9、NSE及S100β水平比较,差异无统计学意义(P>0.05),T2、T3、T4时期研究组MMP-9、NSE及S100β水平低于对照组,差异有统计学意义(P<0.05);研究组不良反应发生率12.51%(4/32),低于对照组的34.39%(11/32),差异有统计学意义(P<0.05)。结论右美托咪定辅助血管内介入栓塞术治疗颅内动脉瘤可降低血清MMP-9、NSE及S100β水平,发挥脑保护作用,且术中血流动力学水平稳定,安全性较高。Objective To investigate the effect of dexmedetomidine on serum matrix metalloproteinase-9(MMP-9),human neuron specific enolase(NSE) and S100β levels in patients with intracranial aneurysm.Methods From June 2014 to June 2016,64 patients with intracranial aneurysms admitted to the Second Affiliated Hospital of Henan University of science and technology were divided into 32 groups according to the filing order.Both groups were treated with intravascular embolization,the study group with dexmedetomidine and the control group with 0.9% sodium chloride injection.The changes of hemodynamic indexes(HR,MAP),MMP-9,NSE,S100β in serum,before anesthesia(T1),after anesthesia(T2),at the beginning of operation(T3) and 6 hours after operation(T4) were compared,and the incidence of adverse reactions was counted.Results There was no significant difference in HR and MAP between the two groups in T1 period(P>0.05).In T2,T3 and T4,HR and MAP levels of the two groups changed,but the change range of HR and MAP in the study group was smaller than that in the control group(P<0.05).There was no significant difference in the levels of MMP-9,NSE and S100β between the two groups in T1 period(P>0.05).The levels of MMP-9,NSE and S100β in the study group were lower than those in the control group at T2,T3 and T4(P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group(P<0.05).Conclusion The level of MMP-9,NSE and S100β in the serum of patients with intracranial aneurysms treated by dexmedetomidine assisted intravascular embolization can be reduced,and the level of hemodynamics is stable and safe during the operation.

关 键 词：颅内动脉瘤 右美托咪定 血管内介入栓塞术 基质金属蛋白酶-9 神经元特异性烯醇化酶 

分 类 号：R739.41[医药卫生—肿瘤]