右美托咪定对机械通气脓毒症患者炎症因子及预后的影响  

Effects of dexmedetomidine on inflammatory factors and prognosis in patients with sepsis undergoing mechanical ventilation

作　　者：杨帆 金慧 龚凌雁 陆相君 YANG Fan;JIN Hui;GONG Lingyan;LU Xiangjun(the Sixth People's Hospital of Nantong,Nantong 226000,China)

机构地区：[1]南通市第六人民医院,江苏南通226000

出　　处：《临床医学研究与实践》2025年第5期37-40,共4页Clinical Research and Practice

基　　金：南通市科技项目-2022基础科学研究面上项目(No.JC12022108)。

摘　　要：目的分析右美托咪定对机械通气脓毒症患者炎症因子及预后的影响。方法以2015年1月至2021年12月我院收治的87例机械通气脓毒症患者作为研究对象,根据随机数字表法将其分为常规组(46例)和观察组(41例)。常规组采用咪达唑仑镇静治疗,观察组采用右美托咪定镇静治疗。比较两组的治疗效果。结果观察组的重症病房入住时长、普通病房入住时长短于常规组,谵妄、多器官功能障碍综合征发生率低于常规组(P<0.05)。治疗后,观察组的降钙素原(PCT)、C反应蛋白(CRP)及肿瘤坏死因子-α(TNF-α)水平低于常规组,白细胞介素-10(IL-10)水平高于常规组(P<0.05)。治疗后,观察组的CD4^(+)、CD4^(+)/CD8^(+)高于常规组,CD8^(+)、CD4^(+)细胞凋亡率及CD8^(+)细胞凋亡率低于常规组(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论右美托咪定可以调节机械通气脓毒症患者的免疫功能,快速消除炎症反应,缩短康复周期,减少不良事件的发生,且不会增加不良反应,值得临床应用及推广。Objective To analyze the effects of dexmedetomidine on inflammatory factors and prognosis in patients with sepsis undergoing mechanical ventilation.Methods A total of 87 patients with mechanical ventilation sepsis admitted in our hospital from January 2015 to December 2021 were included as the study subjects.According to the random number table method,the patients were divided into conventional group(46 cases)and observation group(41 cases).The conventional group was treated with midazolam sedation,and the observation group was treated with dexmedetomidine sedation.The therapeutic effects of the two groups were compared.Results The intensive care unit stay time and general ward stay time in the observation group were shorter than those in the conventional group,and the incidences of delirium and multiple organ dysfunction syndrome were lower than those in the conventional group(P<0.05).After treatment,the levels of procalcitonin(PCT),C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)in the observation group were lower than those in the conventional group,and the level of interleukin-10(IL-10)was higher than that in the conventional group(P<0.05).After treatment,the CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the conventional group,and CD8^(+)and CD4^(+)cell apoptosis rate and CD8^(+)cell apoptosis rate were lower than those in the conventional group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Dexmedetomidine can regulate the immune function of sepsis patients with mechanical ventilation,rapidly eliminate inflammatory response,shorten the recovery period,reduce the occurrence of adverse events,and will not increase adverse reactions.It is worthy of clinical application and promotion.

关 键 词：机械通气 脓毒症 右美托咪定 炎症因子 预后 

分 类 号：R631.2[医药卫生—外科学]