右美托咪啶预处理对开颅手术患者血清S100β蛋白表达的影响
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摘要
目的探讨右美托咪啶预处理对开颅手术患者血清S100β蛋白表达的影响。方法选择2015年1~12月在新乡医学院第一附属医院行择期开颅手术患者42例,随机分为观察组(n=21)和对照组(n=21)。观察组患者麻醉诱导前给予右美托咪定1μg·kg~(-1);对照组患者麻醉诱导前给予等量生理盐水。记录2组患者入室稳定状态(T_1)、给予右美托味定15 min后(T_2)、插管前(T_3)、插管后1 min(T_4)、手术开始(T_5)、手术开始30 min(T_6)、拔管后5 min(T_7)、术后24 h(T_8)时的收缩压(SBP)、舒张压(DBP)和心率(HR)。2组患者分别于T_1、T_7、T_8时采集静脉血,采用酶联免疫吸附(ELISA)法测定S100β蛋白水平。结果与T_1时比较,T_7、T_8时2组患者血清S100β蛋白水平显著升高(P<0.05)。对照组患者T_8时血清S100β蛋白水平高于T_7时(P<0.05);观察组患者T_8与T_7时血清S100β蛋白水平比较差异无统计学意义(P>0.05)。T_1时2组患者血清S100β蛋白水平比较差异无统计学意义(P>0.05)。T_7、T_8时观察组患者血清S100β蛋白水平显著低于对照组(P<0.05)。与T_1时比较,观察组患者T_2~T_8时HR明显下降(P<0.05);SBP、DBP下降不明显(P>0.05)。与T_1比较,对照组患者T_2~T_6时SBP、DBP明显下降(P<0.05);T_7、T_8时下降不明显(P>0.05);对照组患者T_2~T_8时HR变化不明显(P>0.05)。2组患者T_1时SBP、DBP及HR比较差异均无统计学意义(P>0.05);观察组患者T_2~T_6时SBP、DBP高于对照组(P<0.05);T_7、T_8时2组患者SBP、DBP比较差异无统计学意义(P>0.05);观察组患者T_2~T_8时HR低于对照组(P<0.05)。结论右美托咪定预处理可使开颅手术患者血清S100β蛋白水平下降,具有脑细胞保护作用。
Objective To investigate the effect of dexmedetomidine pretreatment on the expression of serum S100β protein of patients with craniotomy surgery. Methods Forty-two patients who underwent craniotomy surgery in the First Affiliated Hospital of Xinxiang Medical University form January 2015 to December 2015 were selected and randomly divided into observation group and control group,with 21 patients in each group. The patients in the observation group were given dexmedetomidine( 1 μg·kg~(-1)) before anesthesia induction; the patients in the control group were given the same volume of physiological saline. The systolic blood pressure( SBP),diastolic blood pressure( DBP) and heart rate( HR) of patients were recorded at the time point of after into the operating room( T_1),15 min after using dexmedetomidine( T_2),before intubation( T_3),1 min after intubation( T_4),at the beginning of surgery( T_5),30 min after beginning of surgery( T_6),5 min after extubation( T_7),24 h after surgery( T_8). The venous blood was drawn at the time point of T_1,T_7 and T_8. The level of serum S100β protein was determined by enzyme linked immunosorbent assay( ELISA). Results The level of serum S100β protein at T_7,T_8 was significantly higher than that at T_1 in the two groups( P < 0. 05). The level of serum S100β protein at T_8 was significantly higher than that at T_7 in the control group( P < 0. 05); there was no statistic difference in the level of serum S100β protein between T_7 and T_8in the observation group( P > 0. 05). There was no statistic difference in the level of serum S100β protein at T_1 between the two groups( P > 0. 05). The level of serum S100β protein at T_7,T_8 in observation group was significantly lower than that in the control group( P < 0. 05). The heart rate( HR) of patients in the observation at T_2-T_8 was significantly lower than that at T_1( P <0. 05); there was no statistic difference in the systolic blood pressure( SBP),diastolic blood pressure( DBP) of patients between T_2-T_8 and T_1in the observation group( P > 0. 05). The SBP,DBP of patients in the control group at T_2-T_6 were significantly lower than those at T_1( P < 0. 05); there was no statistic difference in the SBP,DBP between T_7,T_8 and T_1( P > 0. 05); there was no statistic difference in the HR between T_2-T_8 and T_1( P > 0. 05). There was no statistic difference in the SBP,DBP and HR at T_1 between the two groups( P > 0. 05); the SBP,DBP of patients at T_2-T_6 in the observation group was significanlty higher than that in the control group( P < 0. 05); there was no statistic difference in the SBP,DBP of patients at T_7,T_8 between the two groups( P > 0. 05); the HR of patients at T_2-T_8 in the observation group was significantly lower than that in the control group( P < 0. 05). Conclusion Dexmedetomidine pretreatment can reduce the serum level of S100β protein in patients who undergo craniotomy surgery. It has protection action on brain cell.
Objective To investigate the effect of dexmedetomidine pretreatment on the expression of serum S100β protein of patients with craniotomy surgery. Methods Forty-two patients who underwent craniotomy surgery in the First Affiliated Hospital of Xinxiang Medical University form January 2015 to December 2015 were selected and randomly divided into observation group and control group,with 21 patients in each group. The patients in the observation group were given dexmedetomidine( 1 μg·kg~(-1)) before anesthesia induction; the patients in the control group were given the same volume of physiological saline. The systolic blood pressure( SBP),diastolic blood pressure( DBP) and heart rate( HR) of patients were recorded at the time point of after into the operating room( T_1),15 min after using dexmedetomidine( T_2),before intubation( T_3),1 min after intubation( T_4),at the beginning of surgery( T_5),30 min after beginning of surgery( T_6),5 min after extubation( T_7),24 h after surgery( T_8). The venous blood was drawn at the time point of T_1,T_7 and T_8. The level of serum S100β protein was determined by enzyme linked immunosorbent assay( ELISA). Results The level of serum S100β protein at T_7,T_8 was significantly higher than that at T_1 in the two groups( P < 0. 05). The level of serum S100β protein at T_8 was significantly higher than that at T_7 in the control group( P < 0. 05); there was no statistic difference in the level of serum S100β protein between T_7 and T_8in the observation group( P > 0. 05). There was no statistic difference in the level of serum S100β protein at T_1 between the two groups( P > 0. 05). The level of serum S100β protein at T_7,T_8 in observation group was significantly lower than that in the control group( P < 0. 05). The heart rate( HR) of patients in the observation at T_2-T_8 was significantly lower than that at T_1( P <0. 05); there was no statistic difference in the systolic blood pressure( SBP),diastolic blood pressure( DBP) of patients between T_2-T_8 and T_1in the observation group( P > 0. 05). The SBP,DBP of patients in the control group at T_2-T_6 were significantly lower than those at T_1( P < 0. 05); there was no statistic difference in the SBP,DBP between T_7,T_8 and T_1( P > 0. 05); there was no statistic difference in the HR between T_2-T_8 and T_1( P > 0. 05). There was no statistic difference in the SBP,DBP and HR at T_1 between the two groups( P > 0. 05); the SBP,DBP of patients at T_2-T_6 in the observation group was significanlty higher than that in the control group( P < 0. 05); there was no statistic difference in the SBP,DBP of patients at T_7,T_8 between the two groups( P > 0. 05); the HR of patients at T_2-T_8 in the observation group was significantly lower than that in the control group( P < 0. 05). Conclusion Dexmedetomidine pretreatment can reduce the serum level of S100β protein in patients who undergo craniotomy surgery. It has protection action on brain cell.
引文
[1]JAMES M L,OLSON D M,GRAFFAGNINO C.A pilot study of cerebral and haemodynamic physiological changes during sedation with dexmedetomidine or propofol in patients with acute brain injury[J].Anaesth Intensive Care,2012,40(6):949-957.
[2]闫诺,杨程.右美托咪啶在三叉神经痛合并高血压微血管减压术麻醉中的应用[J].新乡医学院学报,2014,31(12):1011-1014.
[3]贾佳,黄宁.右美托咪定对手术患者血清NSE和S100β蛋白水平的影响[J].实用医学杂志,2012,28(12):2064-2066.
[4]PAPA L.Potential blood-based biomarkers for concussion[J].Sports Med Rthrosc,2016,24(3):108-115.
[5]YAO B,ZHANG L N,AI Y H,et al.Serum S100βis a better biomarker than neuron-specific enolase for sepsis-associated encephalopathy and determining its prognosis:a prospective and observational study[J].Neurochem Res,2014,39(7):1263-1269.
[6]COSAR M,ESER O,FIDAN H,et al.The neuroprotective effect of dexmedetomidine in the hippocampus of rabbits after subarachnoid hemorrhage[J].Surg Neurol,2009,71(1):54-59.
[7]SANDERS R D,XU J,SHU Y,et al.Dexmedetomidine attenuates isoflurane-induced neurocognitive impairment in neonatal rats[J].Anesthesiology,2009,110(5):1077-1085.
[8]罗亮.右美托咪定在颅内血肿清除术中的应用[J].吉林医学,2013,33(34):7125-7127.
[2]闫诺,杨程.右美托咪啶在三叉神经痛合并高血压微血管减压术麻醉中的应用[J].新乡医学院学报,2014,31(12):1011-1014.
[3]贾佳,黄宁.右美托咪定对手术患者血清NSE和S100β蛋白水平的影响[J].实用医学杂志,2012,28(12):2064-2066.
[4]PAPA L.Potential blood-based biomarkers for concussion[J].Sports Med Rthrosc,2016,24(3):108-115.
[5]YAO B,ZHANG L N,AI Y H,et al.Serum S100βis a better biomarker than neuron-specific enolase for sepsis-associated encephalopathy and determining its prognosis:a prospective and observational study[J].Neurochem Res,2014,39(7):1263-1269.
[6]COSAR M,ESER O,FIDAN H,et al.The neuroprotective effect of dexmedetomidine in the hippocampus of rabbits after subarachnoid hemorrhage[J].Surg Neurol,2009,71(1):54-59.
[7]SANDERS R D,XU J,SHU Y,et al.Dexmedetomidine attenuates isoflurane-induced neurocognitive impairment in neonatal rats[J].Anesthesiology,2009,110(5):1077-1085.
[8]罗亮.右美托咪定在颅内血肿清除术中的应用[J].吉林医学,2013,33(34):7125-7127.