右美托咪定对单肺通气患儿炎症反应和氧化应激的影响  

Effects of Dexmedetomidine on Inflammatory Response and Oxidative Stress in Children During One Lung Ventilation

作　　者：肖婷[1] 张水兵 裴冬杰[1] 颜璐璐[1] 屈双权[1] Xiao Ting;Zhang Shuibing;Pei Dongjie;Yan Lulu;Qu Shuangquan(Hunan Children’s Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院,长沙410007

出　　处：《儿科药学杂志》2023年第1期30-34,共5页Journal of Pediatric Pharmacy

基　　金：湖南省自然科学基金项目,编号2019JJ50295;湖南省卫生计生委项目,编号B20180475。

摘　　要：目的:探讨右美托咪定对单肺通气(OLV)患儿炎症反应和氧化应激的影响。方法:收集2019年9月至2020年1月需要OLV的手术患儿,随机分为对照组(C组)和右美托咪定组(D组)各25例,D组麻醉诱导后10 min开始输注右美托咪定0.5μg/kg,随后以0.2μg/kg的速度持续泵入至手术结束。C组用等量生理盐水代替右美托咪定。两组患儿于OLV前(T1)、OLV 30 min(T2)和术毕(T3)进行动脉血气分析,测定两组患儿白细胞介素(IL)-6、核因子(NF)-κB、IL-10、超氧化物歧化酶(SOD)和丙二醛(MDA)的浓度,记录两组患儿不同时间段生命体征及麻醉药物的用量。结果:与T1相比,T2时间段两组患儿氧分压(PO2)降低,肺泡动脉氧分压差(A-aDO2)和呼吸指数(RI)均增高;D组的PO2下降,A-aDO2和RI升高幅度均低于C组(P<0.05);与T1相比,C组患儿单肺通气后NF-κB、IL-6、IL-10和MDA水平均增高,SOD水平降低,D组NF-κB、IL-6、MDA水平均低于C组,IL-10、SOD水平高于C组(P<0.05);D组丙泊酚及瑞芬太尼的用量少于C组(P<0.05)。结论:右美托咪定能改善患儿单肺通气的氧合功能,减少单肺通气引起炎症反应及氧化应激,减少术中麻醉药物的用量。Objective:To investigate the effects of dexmedetomidine on inflammatory response and oxidative stress in children during one lung ventilation(OLV).Methods:Children undergoing OLV from September 2019 to January 2020 were randomly divided into the control group(group C)and the dexmedetomidine group(group D,25 cases for each)according to the random number table.In group D,0.5μg/kg dexmedetomidine was injected after anesthesia induction,and then continued to infuse at a rate of 0.2μg/kg until the end of the surgery.Group C was treated with the same amount of saline instead of dexmedetomidine.Before OLV(T1),30 min after OLV(T2)and after surgery(T3),arterial blood gas analysis was performed and the concentrations of NF-kB,IL-6,IL-10,SOD and MDA were measured.Vital signs and the dosage of narcotic drugs were recorded in the two groups during designed period.Results:In two groups,POwas decreased and A-aDOand RI were increased during T2 compared with T1.POwas decreased in group D,and the degree of the increased A-aDOand RI was lower in group D than in group C(P<0.05).Compared with T1,NF-kB,IL-6,IL-10 and MDA were increased and SOD was decreased after OLV.NF-kB,MDA and IL-6 in group D were lower than that in group C,while IL-10 and SOD were significantly higher than that in group C(P<0.05).The amount of propofol and remifentanil in group D was less than that in group C(P<0.05).Conclusion:Dexmedetomidine could reduce the inflammatory reaction and oxidative stress caused by single lung ventilation,at the same time,reduce the amount of intraoperative anesthesia drug.

关 键 词：右美托咪定 单肺通气 炎症 氧化 应激 

分 类 号：R971[医药卫生—药品]