右美托咪定对肺切除患者围术期免疫功能和应激反应的影响
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摘要
目的探讨右美托咪定对肺切除患者围术期免疫功能和应激反应的影响。方法选择该院自发性气胸行肺切除术患者共160例,美国麻醉师协会(ASA)评分Ⅱ级,随机分为2组,即观察组(应用右美托咪定)和对照组各80例。分析2组患者麻醉诱导前(T0),单肺通气(OLV)60min(T1),手术结束时(T2)的平均动脉压(MAP)、心率(HR)、脑电双频指数(BIS)变化,检测血清超氧化物歧化酶(SOD)、脂质氧化产物丙二醛(MDA)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)的水平变化。结果与对照组比较,观察组T1、T2时段的MAP、HR、BIS变化较小(P<0.05);观察组SOD活性升高,MDA、TNF-α、IL-6、IL-10水平均低于对照组(P<0.05)。结论右美托咪定可有效减轻肺切除患者围术期肺部炎性因子的产生,抑制氧化应激,调节免疫平衡,对肺有较好的保护作用。
Objective To evaluate the effects of dexmedetomidine on immune function and oxidative stress reaction in perioperative in patients with pneumonectomy.Methods A total of 160 cases with spontaneous pneumothorax,ASAⅡwere selected as the research objects,and divided into the observation group(dexmedetomidine group)and the control group randomly,each group of 80 cases.The targets were obtained at three time points:before anesthesia induction(T0),60 min after OLV(T1)and the end of operation(T2).The MAP,HR,BIS were observed and recorded.The SOD,MDA,TNF-α,IL-6,IL-10 were detected.Results Compared to control group,the MAP,HR,BIS of the observation group at T1 and T2 were changed less;the activity of SOD were increased in observation group,the plasma concentration of MDA,TNF-α,IL-6,IL-10 were decreased at T2(P<0.05).Conclusion Dexmedetomidine could effective mitigate inflammatory factor,inhibit oxidative stress,regulate immune balance,and it has positive effect on the lung protection.
Objective To evaluate the effects of dexmedetomidine on immune function and oxidative stress reaction in perioperative in patients with pneumonectomy.Methods A total of 160 cases with spontaneous pneumothorax,ASAⅡwere selected as the research objects,and divided into the observation group(dexmedetomidine group)and the control group randomly,each group of 80 cases.The targets were obtained at three time points:before anesthesia induction(T0),60 min after OLV(T1)and the end of operation(T2).The MAP,HR,BIS were observed and recorded.The SOD,MDA,TNF-α,IL-6,IL-10 were detected.Results Compared to control group,the MAP,HR,BIS of the observation group at T1 and T2 were changed less;the activity of SOD were increased in observation group,the plasma concentration of MDA,TNF-α,IL-6,IL-10 were decreased at T2(P<0.05).Conclusion Dexmedetomidine could effective mitigate inflammatory factor,inhibit oxidative stress,regulate immune balance,and it has positive effect on the lung protection.
引文
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[2]陈亮,孟宪慧.右美托咪定对老年患者肺通气术后认知功能改变的影响[J].中国医药,2015,10(12):1760-1764.
[3]周家龙,梁启胜.右美托咪定肺保护的研究进展[J].中华全科医学,2016,14(8):1386-1388.
[4]吴先荣.右美托咪定肺保护作用的研究进展[J].中国实用医药,2014,9(6):246-248.
[5]YU S,SHI M,LIU C,et al.Time course changes of oxidative stress and inflammation in hyperoxia-induced acute lung injury in rats[J].Iran J Basic Med Sci,2015,18(1):93-103.
[6]MCDONALD C I,FUNG Y L,SHEKAR K,et al.The impact of acute lung injury ECMO and transfusion on oxidative stress and plasma selenium levels in an ovine model[J].J Trace Elem Med Biol,2015,30(12):4-10.
[7]张干,车邦民,梁大干,等.右美托咪定对双腔支气管插管单孔胸腔镜肺大泡切除术患者围术期应激反应的影响[J].牡丹江医学院学报,2015,36(4):25-27.
[8]胡宪文,张野,孔令锁,等.不同剂量右美托咪定抑制气管插管诱发患者心血管效应的比较[J].中华麻醉学杂志,2010,30(11):1304-1306.
[9]刘光杰,白庆林,李海燕,等.右美托咪定联合丙泊酚对单肺通气患者的肺保护作用[J].中国临床医生,2016,45(2):81-83.
[10]胡婧,都鹏飞,贝丹丹.外周血IL-6对新生儿脓毒症诊断价值的Meta分析[J].中国当代儿科杂志,2015,17(11):1176-1182.
[11]张伟,张加强,孟凡民.右美托咪定对单肺通气过程中炎性反应及氧化应激反应的影响[J].临床麻醉学杂志,2013,29(3):229-231.
[12]邓若熹,张晟,张锦枝,等.右美托咪定在全麻手术中对炎症及肺损伤保护作用的探讨[J].中华医院感染学杂志,2013,23(10):2343-2345.