【摘要】：目的研究右美托咪定對心肺轉(zhuǎn)流(CPB)下心臟瓣膜置換術(shù)患者腸黏膜損傷的影響及機制。方法擇期行心瓣膜置換術(shù)的風濕性心臟病患者40例,男17例,女23例,年齡32~64歲,體重40~75kg,ASAⅡ或Ⅲ級,隨機均分為右美托咪定組(D組)和對照組(C組)。麻醉誘導(dǎo)前D組靜注右美托咪定負荷量1μg/kg持續(xù)10min,隨后以0.3μg·kg-1·h-1速率持續(xù)輸注至術(shù)畢;C組輸注等容量生理鹽水。兩組麻醉誘導(dǎo)及維持方法相同。測定CPB開始前(T0)、主動脈阻斷30min(T1)、停CPB即刻(T2)、術(shù)畢(T3)、術(shù)后6h(T4)、24h(T5)時血漿丙二醛(MDA)濃度、總抗氧化能力(T-AOC)和腸型脂肪酸結(jié)合蛋白(I-FABP)濃度。結(jié)果與T0時比較,兩組T1~T5時血漿MDA濃度、I-FABP明顯升高(P0.05),T1~T4時D組血漿T-AOC明顯降低(P0.05)。T1~T5時D組血漿MDA、I-FABP明顯低于C組(P0.05),T1~T4時D組血漿T-AOC明顯高于C組(P0.05)。結(jié)論右美托咪定可以減輕CPB下心臟瓣膜置換術(shù)患者腸黏膜損傷,其機制與抑制氧化應(yīng)激反應(yīng)有關(guān)。
[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.
【作者單位】： 蚌埠醫(yī)學院第一附屬醫(yī)院麻醉科;
【基金】：安徽省高等學校自然科學研究項目(KJ201513024by)
【分類號】：R614

【共引文獻】

中國期刊全文數(shù)據(jù)庫 前10條

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本文編號：2142253