右美托咪定对全弓置换术患者血清炎症因子的影响
Effects of dexmedetomidine on inflammatory factors in patients undergoing aortic arch replacement with cardiopulmonary bypass

目的:探讨右美托咪定对全弓置换术患者血清炎症因子的影响。方法:因A型急性主动脉夹层行全弓置换手术患者32例,将其分为2组:对照组(A组,19例)和右美托咪定组(B组,13例)。B组于进入手术室后静脉滴注负荷量右美托咪定1 μg/kg,以0.6 μg/(kg？h)静脉泵注至手术结束,A组给予等容量生理盐水持续输注。两组患者分别在麻醉诱导前(T1)、手术结束时(T2)、术后4 h(T3)、术后8 h(T4)、术后24 h(T5)测定血清肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1(IL-1)水平。结果:B组在T3、T4、T5时间点血清TNF-α、IL-6、IL-1水平均较A组明显降低(P<0.05)。结论:在全弓置换术中,静注右美托咪定,能够减少术后TNF-α、IL-6、IL-1的释放,抑制炎症反应,改善预后。
Aim: To evaluate the effects of dexmedetomidine on inflammatory factors in patients undergoing the aortic arch replacement with cardiopulmonary bypass.Methods: A total of 32 patients with type A acute aortic dissection undergoing the aortic arth replacement with CPB were allocated into 2 groups depending on the different anesthetic: control group(group A,19 patients)and dexmedetomidine group(group B,13 patients).A loading dose of dexmedetomidine at 1 μg/kg was injected intravenously after induction, followed by continuous infusion at 0.6 μg/(kg？h)until the end of operation in group B. While the equal volume of normal saline was given in group A. Before induction(T1), at the end of operation(T2), and at 4,8 and 24 h the after operation(T3,T4,T5), the serum levels of TNF-α, IL-6, and IL-1 were measured.Results: The serum TNF-α,IL-6,and IL-1 levels at T3,T4,and T5 decreased in group B than those in group A(P<0.05).Conclusion: Dexmedetomidine can reduce the postoperation inflammatory factors such as TNF-α,IL-6,and IL-1 concentrations, thus reducing organ injury during aortic arch replacement