右美托咪定对骨科止血带所致缺血再灌注损伤的氧化应激和炎症因子的影响
发布时间：2018-08-15 11:50
【摘要】：机体组织器官正常代谢、功能的维持,有赖于良好的血液循环。各种原因造成的局部组织器官的缺血,常常使组织细胞发生缺血性损伤,但在动物试验和临床观察中也发现,在一定条件下恢复血液再灌注后,部分动物或患者细胞功能代谢障碍及结构破坏不但未减轻反而加重,因而将这种血液再灌注后缺血性损伤进一步加重的现象称为缺血再灌注损伤(ischemia-reperfusion injury IRI)。临床上骨科止血带多用于肢体手术以达到减少术中失血和保持术野清晰的目的,然而骨科止血带所引发的IRI损伤不但可以造成肢体原发部位的损伤：轻者表现为肌肉晚期纤维化、挛缩、影响功能；重者可致肢体坏死。而且还可以引起继发远隔器官的损伤,特别是侧支循环不丰富,且需氧量高的的器官,如肝、脑、心等。在缺血时间过长,再灌注条件不理想的情况下如高压、高温、高钠、高钙灌注更易引起组织器官的损伤。骨科止血带所致IRI的机制主要是通过以下两种途径实现的,一方面是由于氧自由基引发的脂质过氧化作用,使机体的氧化应激水平升高。另一方面是中性粒细胞在炎症因子参与下介导的炎症反应。氧化应激反应是指机体在遭受各种有害刺激时,体内高活性分子如活性氧自由基氧化程度超出氧化物的清除能力,氧化系统和抗氧化系统失衡,从而导致组织损伤的一种情况。氧自由基主要通过脂质过氧化作用损伤细胞,氧自由基可与生物大分子特别是细胞膜上的不饱和脂肪酸反应,形成脂质过氧化物,破坏物膜。脂质过氧化物降解形成内二醇(malondialdehyde MDA), MDA可使)NA、蛋白质发生交联和聚合,当DNA双股螺旋都发生交联时,细胞分裂时双股螺旋就不能解开,从而导致细胞变性死亡；蛋白质的变性可以就引发酶活性发生改变,影响物质代谢；MDA还可以影响线粒体呼吸链复合物和关键酶的活性使细胞能量代谢紊乱。细胞膜的脂质过氧化作用可以细胞通透性增加,线粒体肿胀,溶酶体释放,从而导致细胞的变性坏死。而清除氧自由基的酶类主要是超氧化物歧化酶(superoxide dismutase SOD),SOD的减少,使再灌注损伤更为严重。炎症因子介导中性粒细胞形成“呼吸爆发”从而引发再灌注局部组织和远隔器官功能障碍。骨科止血带所引发的IRI过程中,肿瘤坏死因子-α[(tumor necrosisfactor-α TNF-α)是最早出现、最敏感的炎症因子之一,而目前认为由TNF-α、白介素-1(interleukin-1IL-1)、白介素-6(interleukin-6IL-6)诱发的炎症反应在很大程度上是通过诱导产生白介素-8(interleukin-8IL-8)为代表的趋化因子所介导的,IL-8在炎症反应中起更直接的介导作用。怎样预防和处理骨科止血带所引发的IRI,减少术后并发症和死亡率一直是困扰麻醉医生和骨科医生的常见问题之一。近几年来缺血预处理作为一种有效的预防手段越来越得到大家重视,所谓缺血预处理(Ischemia preconditioning IPC)是一种能够通过触发机体组织的内源性的保护机制而起到抗IRI的方法。目前IPC作为一种最有效的内源性保护机制越来越受到大家的关注,但其毕竟会对机体造成伤害,而且具有一定的不确定性,主要表现在对实施IPC的最佳时间和次数、患者的个体差异等问题难以准确监测和评估。因此人们根据IPC的机理提出了一种既不损伤器官又能产生预适应效果的的方法—药物预处理(pharmacologic preconditioningPPC)。已有实验证明,多种药物可以起到PPC的效果,如吗啡,七氟醚,异丙酚,甘露醇,肝素等。右美托咪定(dexmedetomidine,DEX)是新一代的高选择性的α2肾上腺素受体激动剂。DEX作用广泛,因其具有镇静催眠、抗惊厥、抗焦虑、稳定血流动力学的作用已被广泛用于辅助检查及门诊短小手术及ICU镇静。同时由于DEX可降低麻醉诱导期插管时机体应激反应及减少麻醉剂与阿片类药物的用量,改善术后患者对气管导管的耐受性,降低患者术后烦躁和谵妄发生率等一系列优势被广泛应用于手术室麻醉。除以上作用外,随着对DEX的深入研究,有研究者证实DEX对机体许多重要脏器如心、脑、肝、肾等IRI具有保护作用。而有关右美托咪定预处理对骨科止血带所致IRI的保护作用的报道还比较少。 目的 观察右美托咪定对骨科止血带所致IRI氧化应激和炎症因子的影响 材料和方法 1病例选择与分组 随机选取南方医科大学附属南方医院创伤骨科和关节骨科择期行下肢手术患者80例,分为2组,其中对照组40例,右美托咪定组(DEX组)40例。患者入选标准如下：无椎管内麻醉禁忌症；ASA分级Ⅰ-Ⅱ,术前心功能Ⅰ-Ⅱ级,EF55%；肝、肺、肾功能正常；无风湿活动指征；无糖尿病,无神经系统、精神疾病史及免疫系统病史；无结核、肝炎、梅毒、艾滋病等传染性疾病。研究对象均为汉族,无亲缘关系,两组性别、年龄、体重指数和止血带应用时间差异无统计学意义(P0.05)。 2麻醉方法 患者术前常规禁食、禁饮,进入手术室后,给予鼻导管2L/min吸氧,及时开放外周静脉通路,监测心电图(ECG),脉搏血氧饱和度(Sp02),无创血压(NIBP)和心率(HR)。所有患者均采用两点穿刺腰硬联合麻醉,感觉平面固定在T10以下,20G留置针对患肢行股静脉穿刺术并固定留置针,肝素封管备用。患肢向近心端驱血后在大腿中上1/3处放置止血带,止血带的压力设置为术前收缩压加100mmHg,时间设定为60min。术中选用复方氯化钠注射液作为补充液体,其给予量按10ml·kg-1·h-1输注。当患者出现血压低于85mmHg或血压下降为基础值的20%时可给予麻黄碱5mg/次,当患者心率低于50次／分时,根据情况可酌情给予阿托品0.25mg／次,当患者Sp0295%时可改用面罩辅助通气。 3右美托咪定给药方法 DEX组静脉给予DEX负荷剂量1μg/kg (10min内输注完毕),10min后改为维持剂量0.5μg/kg/h至手术结束。对照组给予等速度等容量的生理盐水。 4标本处理及检测 分别于T1(上止血带前),T2(松止血带后10min),T3(松止血带后30min),T4(松止血带后60min)共4个时间点抽取手术侧股静脉血5ml,装入试管中,以3000转/min的转速离心5min后低温(-20℃)保存,一周内按ELISA试剂盒方法检测MDA、SOD、TNF-α和IL-8的含量。5统计学处理 所有计量资料均以均数±标准差(x±s)表示,两组均数比较采用独立样本t检验；多个样本均数组间比较采用重复测量的方差分析,计数资料比较采用χ2检验。P0.05认为差异有统计学意义。资料数据的统计应用SPSS19.0(Statistical Package for the Social Science)软件包完成。 结果 1两组病人不同时间点的生命体征情况 两组患者4个时间点NIBP、HR、SpO2组间比较差异无统计学意义(P0.05),两组患者NIBP、HR、SpO2组内比较差异无统计学意义(P0.05)。 2两组病人不同时间点氧化应激标志物MDA的变化 在T1时间点,两组患者血清MDA含量无显著性差异(P0.05)。松止血带后,与T1时间点相比,T2、T3和T4时间点对照组和DEX组患者股静脉血清MDA含量显著升高(P0.05)。但DEX组患者在T2、T3和T4时间点的血清MDA含量显著低于对照组(P0.05)。3两组病人不同时间点氧化应激标志物SOD的变化 在T1时间点,两组患者血清SOD含量无显著性差异(P0.05)。松止血带后,与T1时间点相比,T2、T3和T4时间点对照组和DEX组患者股静脉血清SOD含量显著降低(P0.05)。但DEX组患者在T2、T3和T4时间点的血清SOD含量显著高于对照组(P0.05)。 4两组病人不同时间点炎性因子TNF-a的变化 在T1时间点,两组患者血清TNF-α含量无显著性差异(P0.05)。松止血带后,与T1时间点相比,T2、T3和T4时间点两组患者血清TNF-a含量均显著升高(P0.05)。与对照组相比,DEX组患者在T2、T3和T4时间点的血清TNF-α含量显著降低(P0.05) 5两组病人不同时间点炎性因子IL-8的变化 在T1时间点,两组患者血清IL-8含量无显著性差异(P0.05)。松止血带后,与T1时间点相比,T2、T3和T4时间点两组患者血清IL-8含量均显著升高(P0.05)。与对照组相比,DEX组患者在T2、T3和T4时间点的血清IL-8含量显著降低(P0.05)。 结论 右美托咪定可显著降低骨科止血带所致IRI引起的氧化应激和炎症因子水平的增高。
[Abstract]:Normal metabolism and maintenance of function of tissues and organs depend on good blood circulation. Ischemia of local tissues and organs caused by various causes often causes ischemic injury of tissue and cells. However, in animal experiments and clinical observations, it is also found that under certain conditions, after recovery of blood reperfusion, the functional metabolism of some animals or patients is restored. Obstacles and structural damage are not alleviated but aggravated, and this further aggravation of ischemic injury after reperfusion is called ischemia-reperfusion injury (IRI). The injury of IRI caused by tourniquet can not only cause the injury of the primary part of limb, but also cause the injury of distal organs, especially those organs with low collateral circulation and high oxygen demand, such as liver, brain and heart. Orthopedic tourniquet-induced IRI is mainly achieved by two ways. On the one hand, it is caused by lipid peroxidation induced by oxygen free radicals, which increases the level of oxidative stress. Oxidative stress is a condition in which highly active molecules such as reactive oxygen species (ROS) are oxidized beyond the scavenging capacity of oxides, and the oxidative and antioxidant systems are imbalanced, leading to tissue damage when the body is subjected to various harmful stimuli. Cells are damaged mainly by lipid peroxidation. Oxygen radicals can react with biomolecules, especially unsaturated fatty acids on cell membranes, to form lipid peroxides and destroy membrane. Lipid peroxides degrade to form endodiol (malondialdehyde MDA), MDA can make) NA, and proteins cross-link and polymerize when DNA double helix is present. When cross-linking occurs, the double helix can not be disentangled during cell division, leading to cell degeneration and death; protein denaturation can lead to changes in enzyme activity, affecting substance metabolism; MDA can also affect the activities of mitochondrial respiratory chain complexes and key enzymes, resulting in energy metabolism disorders. The main enzymes scavenging oxygen free radicals are superoxide dismutase (SOD) and the decrease of SOD, which make the reperfusion injury more serious. Inflammatory factors mediate the formation of "respiratory burst" of neutrophils leading to reperfusion. Tumor necrosis factor-alpha (TNF-alpha) is one of the earliest and most sensitive inflammatory factors in the process of IRI induced by orthopaedic tourniquet. At present, TNF-alpha, interleukin-1 (IL-1) and interleukin-6 (IL-6) are considered to be the most sensitive inflammatory factors. Interleukin-8 (IL-8) plays a more direct role in mediating inflammation by inducing the production of chemokines such as interleukin-8 (IL-8). How to prevent and treat IRI caused by orthopaedic tourniquets and reduce postoperative complications and mortality has been a common problem for anesthesiologists and orthopedists. In recent years, ischemic preconditioning (IPC) has attracted more and more attention as an effective preventive measure. The so-called ischemic preconditioning (IPC) is a method that can resist IRI by triggering the endogenous protective mechanism of organism tissues. People are concerned, but after all, it will do harm to the body, and has certain uncertainty, mainly in the implementation of IPC in the best time and frequency, individual differences between patients and other issues difficult to accurately monitor and assess. Drug preconditioning (PPC). It has been shown that a variety of drugs can play a role in PPC, such as morphine, sevoflurane, propofol, mannitol, heparin, etc. Anti-convulsion, anti-anxiety and hemodynamic stabilization have been extensively used in adjuvant examinations, short-term outpatient surgery and ICU sedation. DEX can also reduce stress response during anesthesia induction, reduce the dosage of anesthetics and opioids, improve the patient's tolerance to tracheal catheters, and reduce postoperative irritability and irritability. A series of advantages, such as the incidence of delirium, have been widely used in operating room anesthesia. In addition to these effects, with the in-depth study of DEX, some researchers have confirmed that DEX has protective effects on many important organs such as heart, brain, liver and kidney. The protective effects of dexmedetomidine preconditioning on IRI caused by orthopedic tourniquet are also compared. Less.
objective
To observe the effect of dexmedetomidine on IRI oxidative stress and inflammatory factors in Department of orthopedics tourniquet
Materials and methods
1 case selection and grouping
Eighty patients who underwent selective lower limb surgery in the Department of Traumatic Orthopaedics and Arthroplasty of Southern Hospital Affiliated to Southern Medical University were randomly selected and divided into two groups, 40 in the control group and 40 in the dexmedetomidine group (DEX group). Normal; No indication of rheumatic activity; No diabetes mellitus, no history of nervous system, mental illness and immune system disease; No tuberculosis, hepatitis, syphilis, AIDS and other infectious diseases. The subjects were all Han nationality, unrelated. There was no significant difference in gender, age, body mass index and tourniquet application time between the two groups (P 0.05).
2 anesthesia methods
Patients were given oxygen inhalation through nasal catheter for 2 L/min after entering the operating room. Peripheral venous access was opened in time. Electrocardiogram (ECG), pulse oxygen saturation (Sp02), noninvasive blood pressure (NIBP) and heart rate (HR) were monitored. The pressure of the tourniquet was set as preoperative systolic blood pressure plus 100 mmHg for 60 minutes. Compound sodium chloride injection was used as a supplementary fluid during the operation. The dosage was infused at 10 ml kg 1 h 1. Ephedrine was given 5 mg/time when the blood pressure was below 85 mmHg or 20% of the baseline. Atropine was given 0.25 mg/time when the heart rate was below 50 beats/minute, and mask-assisted ventilation was used when Sp0295%.
3 dexmedetomidine administration
In DEX group, the loading dose of DEX was 1 ug/kg (10 minutes after infusion), and the maintenance dose was 0.5 ug/kg/h after 10 minutes until the end of operation.
4 sample handling and testing
The femoral vein blood samples were collected at T1 (before the tourniquet), T2 (10 minutes after the tourniquet loosening), T3 (30 minutes after the tourniquet loosening), T4 (60 minutes after the tourniquet loosening). The blood samples were stored in a test tube at a rotating speed of 3000 rpm for 5 minutes at a low temperature (-20 C). The contents of MDA, SOD, TNF-alpha and IL-8 were detected by ELISA kit within one week. Study treatment
All measurements were expressed as mean [standard deviation] (x [s], and the mean comparisons between the two groups were performed by independent sample t test; multiple sample mean comparisons were performed by repeated measurements of variance analysis; and the count data were compared by_2 test. P 0.05 showed that the difference was statistically significant. Ocial Science) the software package is completed.
Result
1 vital signs of two groups of patients at different time points.
There was no significant difference in NIBP, HR and SpO2 between the two groups at 4 time points (P 0.05). There was no significant difference in NIBP, HR and SpO2 between the two groups (P 0.05).
2 Changes of oxidative stress marker MDA in two groups of patients at different time points
There was no significant difference in serum MDA levels between the two groups at T1 time point (P 0.05). After loosening tourniquet, the serum MDA levels in the control group and the DEX group at T2, T 3 and T4 time points were significantly higher than those at T1 time point (P 0.05). However, the serum MDA levels in the DEX group at T2, T 3 and T4 time points were significantly lower than those in the control group (P 0.05). Changes of marker SOD in point of oxidative stress
There was no significant difference in serum SOD levels between the two groups at T1 time point (P 0.05). After relaxation of tourniquet, the serum SOD levels in femoral vein of the control group and the DEX group at T2, T3 and T4 time points were significantly lower than those of the control group (P 0.05).
4 the change of inflammatory factor TNF-a in two groups of patients at different time points
There was no significant difference in serum TNF-a between the two groups at T1 time point (P 0.05). After loosening tourniquet, the serum TNF-a levels of the two groups at T2, T3 and T4 time points were significantly higher than those at T1 time point (P 0.05). Compared with the control group, the serum TNF-a levels of the DEX group at T2, T3 and T4 time points were significantly lower (P 0.05).
5 the change of inflammatory factor IL-8 in two groups of patients at different time points
There was no significant difference in serum IL-8 between the two groups at T1 time point (P 0.05). After loosening tourniquet, the serum IL-8 levels of the two groups at T2, T3 and T4 time points were significantly higher than those at T1 time point (P 0.05). Compared with the control group, the serum IL-8 levels of the DEX group at T2, T3 and T4 time points were significantly lower (P 0.05).
conclusion
Dexmedetomidine significantly decreased oxidative stress and inflammatory factors induced by IRI in patients with orthopedic tourniquet.
【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614
本文编号：2184112
[Abstract]:Normal metabolism and maintenance of function of tissues and organs depend on good blood circulation. Ischemia of local tissues and organs caused by various causes often causes ischemic injury of tissue and cells. However, in animal experiments and clinical observations, it is also found that under certain conditions, after recovery of blood reperfusion, the functional metabolism of some animals or patients is restored. Obstacles and structural damage are not alleviated but aggravated, and this further aggravation of ischemic injury after reperfusion is called ischemia-reperfusion injury (IRI). The injury of IRI caused by tourniquet can not only cause the injury of the primary part of limb, but also cause the injury of distal organs, especially those organs with low collateral circulation and high oxygen demand, such as liver, brain and heart. Orthopedic tourniquet-induced IRI is mainly achieved by two ways. On the one hand, it is caused by lipid peroxidation induced by oxygen free radicals, which increases the level of oxidative stress. Oxidative stress is a condition in which highly active molecules such as reactive oxygen species (ROS) are oxidized beyond the scavenging capacity of oxides, and the oxidative and antioxidant systems are imbalanced, leading to tissue damage when the body is subjected to various harmful stimuli. Cells are damaged mainly by lipid peroxidation. Oxygen radicals can react with biomolecules, especially unsaturated fatty acids on cell membranes, to form lipid peroxides and destroy membrane. Lipid peroxides degrade to form endodiol (malondialdehyde MDA), MDA can make) NA, and proteins cross-link and polymerize when DNA double helix is present. When cross-linking occurs, the double helix can not be disentangled during cell division, leading to cell degeneration and death; protein denaturation can lead to changes in enzyme activity, affecting substance metabolism; MDA can also affect the activities of mitochondrial respiratory chain complexes and key enzymes, resulting in energy metabolism disorders. The main enzymes scavenging oxygen free radicals are superoxide dismutase (SOD) and the decrease of SOD, which make the reperfusion injury more serious. Inflammatory factors mediate the formation of "respiratory burst" of neutrophils leading to reperfusion. Tumor necrosis factor-alpha (TNF-alpha) is one of the earliest and most sensitive inflammatory factors in the process of IRI induced by orthopaedic tourniquet. At present, TNF-alpha, interleukin-1 (IL-1) and interleukin-6 (IL-6) are considered to be the most sensitive inflammatory factors. Interleukin-8 (IL-8) plays a more direct role in mediating inflammation by inducing the production of chemokines such as interleukin-8 (IL-8). How to prevent and treat IRI caused by orthopaedic tourniquets and reduce postoperative complications and mortality has been a common problem for anesthesiologists and orthopedists. In recent years, ischemic preconditioning (IPC) has attracted more and more attention as an effective preventive measure. The so-called ischemic preconditioning (IPC) is a method that can resist IRI by triggering the endogenous protective mechanism of organism tissues. People are concerned, but after all, it will do harm to the body, and has certain uncertainty, mainly in the implementation of IPC in the best time and frequency, individual differences between patients and other issues difficult to accurately monitor and assess. Drug preconditioning (PPC). It has been shown that a variety of drugs can play a role in PPC, such as morphine, sevoflurane, propofol, mannitol, heparin, etc. Anti-convulsion, anti-anxiety and hemodynamic stabilization have been extensively used in adjuvant examinations, short-term outpatient surgery and ICU sedation. DEX can also reduce stress response during anesthesia induction, reduce the dosage of anesthetics and opioids, improve the patient's tolerance to tracheal catheters, and reduce postoperative irritability and irritability. A series of advantages, such as the incidence of delirium, have been widely used in operating room anesthesia. In addition to these effects, with the in-depth study of DEX, some researchers have confirmed that DEX has protective effects on many important organs such as heart, brain, liver and kidney. The protective effects of dexmedetomidine preconditioning on IRI caused by orthopedic tourniquet are also compared. Less.
objective
To observe the effect of dexmedetomidine on IRI oxidative stress and inflammatory factors in Department of orthopedics tourniquet
Materials and methods
1 case selection and grouping
Eighty patients who underwent selective lower limb surgery in the Department of Traumatic Orthopaedics and Arthroplasty of Southern Hospital Affiliated to Southern Medical University were randomly selected and divided into two groups, 40 in the control group and 40 in the dexmedetomidine group (DEX group). Normal; No indication of rheumatic activity; No diabetes mellitus, no history of nervous system, mental illness and immune system disease; No tuberculosis, hepatitis, syphilis, AIDS and other infectious diseases. The subjects were all Han nationality, unrelated. There was no significant difference in gender, age, body mass index and tourniquet application time between the two groups (P 0.05).
2 anesthesia methods
Patients were given oxygen inhalation through nasal catheter for 2 L/min after entering the operating room. Peripheral venous access was opened in time. Electrocardiogram (ECG), pulse oxygen saturation (Sp02), noninvasive blood pressure (NIBP) and heart rate (HR) were monitored. The pressure of the tourniquet was set as preoperative systolic blood pressure plus 100 mmHg for 60 minutes. Compound sodium chloride injection was used as a supplementary fluid during the operation. The dosage was infused at 10 ml kg 1 h 1. Ephedrine was given 5 mg/time when the blood pressure was below 85 mmHg or 20% of the baseline. Atropine was given 0.25 mg/time when the heart rate was below 50 beats/minute, and mask-assisted ventilation was used when Sp0295%.
3 dexmedetomidine administration
In DEX group, the loading dose of DEX was 1 ug/kg (10 minutes after infusion), and the maintenance dose was 0.5 ug/kg/h after 10 minutes until the end of operation.
4 sample handling and testing
The femoral vein blood samples were collected at T1 (before the tourniquet), T2 (10 minutes after the tourniquet loosening), T3 (30 minutes after the tourniquet loosening), T4 (60 minutes after the tourniquet loosening). The blood samples were stored in a test tube at a rotating speed of 3000 rpm for 5 minutes at a low temperature (-20 C). The contents of MDA, SOD, TNF-alpha and IL-8 were detected by ELISA kit within one week. Study treatment
All measurements were expressed as mean [standard deviation] (x [s], and the mean comparisons between the two groups were performed by independent sample t test; multiple sample mean comparisons were performed by repeated measurements of variance analysis; and the count data were compared by_2 test. P 0.05 showed that the difference was statistically significant. Ocial Science) the software package is completed.
Result
1 vital signs of two groups of patients at different time points.
There was no significant difference in NIBP, HR and SpO2 between the two groups at 4 time points (P 0.05). There was no significant difference in NIBP, HR and SpO2 between the two groups (P 0.05).
2 Changes of oxidative stress marker MDA in two groups of patients at different time points
There was no significant difference in serum MDA levels between the two groups at T1 time point (P 0.05). After loosening tourniquet, the serum MDA levels in the control group and the DEX group at T2, T 3 and T4 time points were significantly higher than those at T1 time point (P 0.05). However, the serum MDA levels in the DEX group at T2, T 3 and T4 time points were significantly lower than those in the control group (P 0.05). Changes of marker SOD in point of oxidative stress
There was no significant difference in serum SOD levels between the two groups at T1 time point (P 0.05). After relaxation of tourniquet, the serum SOD levels in femoral vein of the control group and the DEX group at T2, T3 and T4 time points were significantly lower than those of the control group (P 0.05).
4 the change of inflammatory factor TNF-a in two groups of patients at different time points
There was no significant difference in serum TNF-a between the two groups at T1 time point (P 0.05). After loosening tourniquet, the serum TNF-a levels of the two groups at T2, T3 and T4 time points were significantly higher than those at T1 time point (P 0.05). Compared with the control group, the serum TNF-a levels of the DEX group at T2, T3 and T4 time points were significantly lower (P 0.05).
5 the change of inflammatory factor IL-8 in two groups of patients at different time points
There was no significant difference in serum IL-8 between the two groups at T1 time point (P 0.05). After loosening tourniquet, the serum IL-8 levels of the two groups at T2, T3 and T4 time points were significantly higher than those at T1 time point (P 0.05). Compared with the control group, the serum IL-8 levels of the DEX group at T2, T3 and T4 time points were significantly lower (P 0.05).
conclusion
Dexmedetomidine significantly decreased oxidative stress and inflammatory factors induced by IRI in patients with orthopedic tourniquet.
【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614
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