右美托咪定预处理对瓣膜置换术患者缺血后心肌的影响

发布时间：2018-04-11 00:32

本文选题：右美托咪定 + 心肺转流术　；参考：《安徽医科大学学报》2017年06期

【摘要】：目的评价右美托咪定预处理对体外循环下二尖瓣置换术患者心肌缺血再灌注损伤的影响。方法择期行心脏二尖瓣置换术患者60例,随机分为两组:对照组和右美托咪定组(DEX组),分别在主动脉阻断前30 min给予0.9%生理盐水10 ml、0.6 mg/kg右美托咪定10 ml,微量泵注射10 min完成。收集麻醉诱导前(H0)、气管插管后(H1)、给药前(H2)、给药后(H3)、体外循环(CPB)后即刻(H4)、CPB后30 min(H5)、CPB后1 h(H6)、CPB后2 h(H7)患者的平均动脉压(MAP)、心率(HR)。在麻醉诱导前(T0)、主动脉开放2 h(T1)、4 h(T2)、8 h(T3)、12 h(T4)抽取桡动脉血样2 ml。测定心肌肌钙蛋白I(c Tn I)、肌酸激酶同工酶(CKMB)、丙二醛(MDA)浓度和超氧化物歧化酶(SOD)活性。结果与H0相比,对照组在H5、H6 MAP明显降低,HR明显升高(P0.01),DEX组无明显变化;与对照组相比,T1~T4时DEX组患者c Tn I、CK-MB和血清MDA明显降低,SOD明显升高(P0.01)。结论右美托咪定预处理可减轻CPB下心脏瓣膜置换术患者心肌缺血再灌注损伤,其机制与抑制氧化应激反应有关。
[Abstract]:Objective to evaluate the effect of dexmetomidine preconditioning on myocardial ischemia reperfusion injury in patients undergoing mitral valve replacement under cardiopulmonary bypass.Methods Sixty patients undergoing mitral valve replacement were randomly divided into two groups: control group and dexmetidine group. They were given 0.9% normal saline 10 ml of 0.6 mg/kg dexmetidine 10 ml 30 min before aortic occlusion and micropump injection of 10 min.Before anesthesia induction, 2 ml of radial artery blood samples were taken from the patients with T0, T1, T1, T1, T2, T2, T2, T3, T3, T4, and T4, respectively, in which the aorta was opened for 2 h.The concentration of cardiac troponin I, creatine kinase isozyme, malondialdehyde (MDA) and the activity of superoxide dismutase (SOD) were measured.Results compared with H0, the control group had no significant change in H5, H6 MAP, HR, P0.01DX group, and compared with the control group, the DEX group had significantly lower cTnI CK-MB and higher serum MDA level than the control group at T1 + T4, and the serum MDA level was significantly lower than that of the control group, and the serum MDA level was significantly lower than that of the control group, and the serum MDA level was significantly lower than that of the control group.Conclusion dexmetomidine pretreatment can reduce myocardial ischemia-reperfusion injury in patients undergoing cardiac valve replacement under CPB, and its mechanism is related to the inhibition of oxidative stress.
【作者单位】：安徽医科大学第二附属医院麻醉科;
【基金】：国家自然科学基金青年基金项目(编号:81200089)
【分类号】：R614

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