右美托咪定对体外循环心脏瓣膜置换患者术后肾功能的影响

发布时间：2018-09-05 20:30

【摘要】：目的观察右美托咪定对体外循环下心脏瓣膜置换患者术后肾功能的影响。方法 50例风湿性心脏病患者随机分为两组:右美托咪定组(D组,n=25)及对照组(C组,n=25)。于术前(T0),术后24h(T1)、48h(T2)、72h(T3)、96h(T4)采集动脉血,7600全自动生化分析仪(日立)检查血清肌酐、血尿素氮(BUN)、血清胱抑素-C(Cys-C)、肾小球滤过率(GFR)。结果与T0比较,C组术后各时间点BUN、Cys-C值均明显升高,而GFR降低,差异有统计学意义(P0.05);从T2时点后各时间点BUN、Cys-C逐渐下降,而GFR逐渐升高,与T0比较,差异有统计学意义(P0.05),但T4时点各指标均未恢复到术前;与T0比较,血清肌酐术后各时间点差异无统计学意义(P0.05)。D组血清肌酐T2、T3、T4与T0比较均降低,差异有统计学意义(P0.05)。两组间同时点各指标比较差异无统计学意义(P0.05)。结论右美托咪定可促进体外循环下心脏瓣膜置换术患者术后肾功能的恢复,对肾脏有一定的保护作用。
[Abstract]:Objective to observe the effect of dexmetomidine on renal function after cardiac valve replacement under cardiopulmonary bypass (CPB). Methods 50 patients with rheumatic heart disease were randomly divided into two groups: dexmetomidine group (group D) and control group (group C). Serum creatinine, serum urea nitrogen (BUN), cystatin C (Cys-C) and glomerular filtration rate (GFR).) were collected 24 hours after operation (T 0), 48 h (T 2) and 72 h (T 3) and 96 h (T 4), respectively. Serum creatinine (creatinine), serum cystatin C (Cys-C) and glomerular filtration rate (GFR).) were detected by automatic biochemical analyzer 7600 (Hitachi). Results compared with T0, the BUN,Cys-C value of group C was significantly higher than that of group T0, but GFR decreased significantly (P0.05), BUN,Cys-C decreased gradually at each time point after T2, and GFR increased gradually, compared with T0. The difference was statistically significant (P0.05), but all the indexes of T4 did not return to preoperative; compared with T0, there was no significant difference in serum creatinine after operation (P0.05). Group D serum creatinine T2T2T3T4 decreased compared with T0, the difference was statistically significant (P0.05). There was no significant difference between the two groups (P0.05). Conclusion dexmetomidine can promote the recovery of renal function after cardiac valve replacement under cardiopulmonary bypass, and has a protective effect on the kidney.
【作者单位】：四川省宜宾市第一人民医院麻醉科;遵义医学院麻醉系;
【基金】：四川省卫计委资助项目资助项目(110601) 四川省宜宾市科技局基金资助项目(2014SF015)
【分类号】：R614

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