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| 右美托咪定对经皮冠状动脉介入治疗患者氧化应激的影响 |
| Effect of dexmedetomidine on oxidative stress in patients undergoing percutaneous coronary intervention |
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| DOI： |
| 中文关键词: 右美托咪定 冠状动脉 心肌再灌注损伤 氧化应激 清醒镇静 |
| 英文关键词: Dexmedetomidine Coronary artery Myocardial reperfusion injury Oxidative stress Conscious sedation |
| 基金项目: |
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| 中文摘要: |
| 目的 评价右美托咪定对经皮冠状动脉介入治疗 (percutaneous coronary intervention， PCI)患者氧化应激的影响。方法 选择急性心肌梗死需行急诊PCI患者50例，男39例，女11例，年龄47～79岁，体重45～83 kg，ASA Ⅲ或Ⅳ级，采用随机数字表法将患者分为右美托咪定组 (D组)和对照组 (C组)，每组25例。D组麻醉诱导前30 min静脉泵注负荷剂量右美托咪定0.5 μg/kg，泵注时间10 min，随后持续静脉泵注右美托咪定0.2～1.0 μg·kg-1·h-1至术毕;C组采用同样方法 静脉泵注等量生理盐水。根据RASS镇静程度评估表，维持RASS评分-2～2分。于麻醉诱导前 (T0)、术毕 (T1)、术后6 h (T2)和24 h (T3)采集颈静脉血4 ml，分别进行中性粒细胞 (PMN)计数、血清丙二醛 (MDA)浓度和超氧化物歧化酶 (SOD)活性测定。记录术中低血压、心动过缓和低氧血症等不良反应的发生情况。结果 与T0时比较，T1～T3 时两组血清PMN计数、MDA浓度均明显升高，血清SOD活性明显降低 (P<0.01或P<0.05);T1～T3时D组PMN计数、MDA浓度均明显低于C组，血清SOD活性明显高于C组 (P<0.05)。两组患者术中低血压、心动过缓和低氧血症的发生率差异无统计学意义。结论 持续静脉泵注右美托咪定0.5 μg/kg，可以更好地抑制PCI患者的氧化应激反应，有助于减轻心肌缺血-再灌注损伤。 |
| 英文摘要: |
| Objective To evaluate the effect of continuous infusion of dexmedetomidine on the oxidative stress in patients undergoing percutaneous coronary intervention (PCI). Methods Fifty patients, with acute myocardial infarction who required for emergency PCI, 39 males, 11 females, aged 47-79 years, weighting 45-83 kg, ASA physical status Ⅲ or Ⅳ, were selected and randomly divided into two groups (n=25 each) using a random number table: the control group (group C) and the dexmedetomidine group (group D). In group D, a loading dose of dexmedetomidine 0.5 μg/kg was infused intravenously for 10 min before surgery, and then dexmedetomidine was infused at a rate of 0.2-1.0 μg·kg-1·h-1 during the operation until the end of operation. Patients in group C received the same dose saline in the same way. RASS score was maintained at -2-2 scores in the two groups. Blood samples were collected before the anesthesia induction (T0), at the end of the operation (T1), 6 h after the operation (T2) and 24 h after the operation (T3) to determine the observed changes of PMN, SOD and MDA. The intraoperative adverse reactions including hypotension, bradycardia and hypoxemia were recorded. Results Compared with T0, the number of PMN and the serum concentration of MDA at T1-T3 significantly increased, while effective serum SOD at T1-T3 significantly decreased (P<0.01 or P<0.05). The serum concentration of MDA and the number of PMN at T1-T3 in group D were significantly lower than those in group C, while the effective serum SOD was significantly higher than that in group C (P<0.05). There was no significant difference of intraoperative adverse reactions including hypotension, bradycardia and hypoxemia between the two groups. Conclusion Continuous infusion of dexmedetomidine can decrease oxidative stress thus to alleviate myocardial reperfusion injury. |
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