右美托咪定对老年增生性糖尿病视网膜病变玻璃体切除术糖化血红蛋白水平影响及其与白细胞介素-18、骨桥蛋白的相关性

发布时间：2018-05-24 10:30

本文选题：麻醉 + 增殖性糖尿病视网膜病变　；参考：《中国老年学杂志》2017年19期

【摘要】：目的探讨右美托咪定对老年增生性糖尿病性视网膜病变(PDR)玻璃体切除术患者血糖影响及与白细胞介素(IL)-18、骨桥蛋白(OPN)的相关性。方法行玻璃体切除的PDR患者按照手术麻醉方式分为观察组36例与对照组39例。对照组采用局部麻醉,观察组在对照组基础上术前辅助右美托咪定。结果两组术前、手术结束时及术后3 d糖化血红蛋白(HbA1c)差异均无统计学意义(P0.05)。观察组术后1 d HbA1c水平明显低于对照组(P0.05)。观察组术后1 d HbA1c水平高于术前,对照组术后1 d HbA1c水平分别高于术前及手术结束时,术后3 d HbA1c水平下降并恢复正常(P0.05);观察组术后1 d房水中IL-18明显低于对照组,观察组患者术后1 d房水中OPN则高于对照组,差异均具有统计学意义(P0.05);观察组术后1 d房水中IL-18与HbA1c呈正相关(r=0.368,P=0.027),观察组术后1 d房水OPN与HbA1c呈负相关(r=-0.331,P=0.049)。结论右美托咪定对PDR玻璃体切除术局麻前后血糖影响较小,麻醉效果较好,房水IL-18、OPN改变与血糖波动存在一定的线性关系。
[Abstract]:Objective to investigate the effect of dexmetomidine on blood glucose in elderly patients with proliferative diabetic retinopathy (PDR) after vitrectomy and its correlation with interleukin (IL) IL-18 and osteopontin (OPN). Methods PDR patients undergoing vitrectomy were divided into observation group (n = 36) and control group (n = 39). The control group was treated with local anesthesia, and the observation group was treated with dexmetomidine before operation on the basis of the control group. Results there was no significant difference in HbA1c between the two groups before operation, at the end of operation and 3 days after operation. The level of HbA1c in the observation group was significantly lower than that in the control group on 1 day after operation (P 0.05). The level of HbA1c in the observation group was higher than that before operation 1 day after operation, the HbA1c level in the control group was higher than that before operation and at the end of the operation, the HbA1c level decreased and returned to normal on the 3rd day after operation, and the IL-18 in aqueous humor of the observation group was significantly lower than that of the control group on the first day after operation. The OPN in aqueous humor water in the observation group was higher than that in the control group on the 1st day after operation, the difference was statistically significant (P 0.05), the IL-18 and HbA1c in the aqueous humor water in the observation group were positively correlated with HbA1c on the 1st day after operation, and there was a negative correlation between OPN and HbA1c in the observation group on the 1st day after operation. Conclusion dexmetomidine has little effect on blood glucose before and after PDR vitrectomy, and the effect of anesthesia is better. There is a linear relationship between changes of IL-18 OPN in aqueous humor and blood glucose fluctuation.
【作者单位】：济南市第三人民医院麻醉科;济南市中心医院眼科;
【分类号】：R614

【相似文献】