右美托咪定对心脏瓣膜置换术患者肠黏膜损伤的影响
发布时间：2018-07-24 18:21
【摘要】：目的研究右美托咪定对心肺转流(CPB)下心脏瓣膜置换术患者肠黏膜损伤的影响及机制。方法择期行心瓣膜置换术的风湿性心脏病患者40例,男17例,女23例,年龄32~64岁,体重40~75kg,ASAⅡ或Ⅲ级,随机均分为右美托咪定组(D组)和对照组(C组)。麻醉诱导前D组静注右美托咪定负荷量1μg/kg持续10min,随后以0.3μg·kg-1·h-1速率持续输注至术毕;C组输注等容量生理盐水。两组麻醉诱导及维持方法相同。测定CPB开始前(T0)、主动脉阻断30min(T1)、停CPB即刻(T2)、术毕(T3)、术后6h(T4)、24h(T5)时血浆丙二醛(MDA)浓度、总抗氧化能力(T-AOC)和肠型脂肪酸结合蛋白(I-FABP)浓度。结果与T0时比较,两组T1~T5时血浆MDA浓度、I-FABP明显升高(P0.05),T1~T4时D组血浆T-AOC明显降低(P0.05)。T1~T5时D组血浆MDA、I-FABP明显低于C组(P0.05),T1~T4时D组血浆T-AOC明显高于C组(P0.05)。结论右美托咪定可以减轻CPB下心脏瓣膜置换术患者肠黏膜损伤,其机制与抑制氧化应激反应有关。
[Abstract]:Objective to study the effect and mechanism of dexmetomidine on intestinal mucosal injury in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB). Methods 40 patients (17 males and 23 females) with rheumatic heart disease undergoing cardiac valve replacement were randomly divided into dexmetomidine group (group D) and control group (group C). Before anesthesia induction, group D received dexmetomidine (1 渭 g/kg) intravenously for 10 minutes, and then continued infusion at 0.3 渭 g kg-1 h-1 rate until the end of operation in group C. Anesthesia induction and maintenance were the same in both groups. Plasma malondialdehyde (MDA) concentration, total antioxidant capacity (T-AOC) and intestinal fatty acid binding protein (I-FABP) were measured before CPB (T0), 30min (T1), immediately after CPB (T2), after operation (T3), 6h (T4) and 24h (T5) postoperatively. Results compared with T0, plasma MDA concentration and I-FABP in group D were significantly higher than those in group T _ (0) (P0.05). Plasma T-AOC in group D was significantly lower than that in group D at T _ (1) T _ (4). Plasma T-AOC in group D was significantly lower than that in group C (P 0.05) at T _ (1) T _ (4) and T _ (1) T _ (4) (P0.05). Conclusion dexmetidine can reduce intestinal mucosal injury in patients undergoing cardiac valve replacement under CPB, and its mechanism is related to inhibition of oxidative stress response.
【作者单位】： 蚌埠医学院第一附属医院麻醉科;
【基金】：安徽省高等学校自然科学研究项目(KJ201513024by)
【分类号】：R614
[Abstract]:Objective to study the effect and mechanism of dexmetomidine on intestinal mucosal injury in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB). Methods 40 patients (17 males and 23 females) with rheumatic heart disease undergoing cardiac valve replacement were randomly divided into dexmetomidine group (group D) and control group (group C). Before anesthesia induction, group D received dexmetomidine (1 渭 g/kg) intravenously for 10 minutes, and then continued infusion at 0.3 渭 g kg-1 h-1 rate until the end of operation in group C. Anesthesia induction and maintenance were the same in both groups. Plasma malondialdehyde (MDA) concentration, total antioxidant capacity (T-AOC) and intestinal fatty acid binding protein (I-FABP) were measured before CPB (T0), 30min (T1), immediately after CPB (T2), after operation (T3), 6h (T4) and 24h (T5) postoperatively. Results compared with T0, plasma MDA concentration and I-FABP in group D were significantly higher than those in group T _ (0) (P0.05). Plasma T-AOC in group D was significantly lower than that in group D at T _ (1) T _ (4). Plasma T-AOC in group D was significantly lower than that in group C (P 0.05) at T _ (1) T _ (4) and T _ (1) T _ (4) (P0.05). Conclusion dexmetidine can reduce intestinal mucosal injury in patients undergoing cardiac valve replacement under CPB, and its mechanism is related to inhibition of oxidative stress response.
【作者单位】： 蚌埠医学院第一附属医院麻醉科;
【基金】：安徽省高等学校自然科学研究项目(KJ201513024by)
【分类号】：R614
【共引文献】
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