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右旋美托咪啶对开颅患者炎症反应的干预作用
Intervention effects of dexmedetomidine on inflammatory response following craniotomy in patients
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DOI:
作者:
任长和
ren chang he
作者单位:
四川省泸州市泸州医学院附属医院
the First Affiliated Hospital of Luzhou Medical College
关键词:
脑保护;右美托咪啶;炎症;MMSE;IL-6;TNF-α
Neuroprotection; Dexmedetomidine; MMSE; Inflammation; IL-6; NF-α.
摘要:
【摘 要】目的:观察右旋美托咪啶(dexmedetomidine,DEX)对开颅患者血清IL-6、TNF-α的影响和术前术后24小时MMSE(Mini Mental State Examination)的变化,探讨DEX对开颅手术患者炎症反应及认知功能的干预作用。方法:45例择期开颅手术患者,随机分成C组(对照组)、DEXⅠ组(DEX负荷量和维持量为0.5ug/kg和0.5ug/kg/h)及DEXⅡ组(DEX负荷量和维持量为1ug/kg和1ug/kg/h)。术前术后24小时对所有患者进行MMSE评分;用放射免疫法检测T0(术前24小时)、T1(切开硬脑膜后)、 T2(手术结束时)及 T3(术后24小时)时点血清IL-6、TNF-α。结果:1. DEX能改善术后早期MMSE评分。2. DEX能降低血清IL-6、TNF-α浓度,且DEXⅡ组作用更明显(p<0.05)。结论:DEX能够降低开颅患者术后血清IL-6和TNF-α的浓度,减轻炎症反应,提高MMSE评分。
Abstract Objective: To observe the effect of dexmedetomidine (DEX) on interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) levels, and change of Mini Mental State Examination (MMSE) scores 24 hours before surgery and 24 hours after surgery in patients undergoing craniotomy,and to explore the cognitive function and the intervention effects of dexmedetomidine on inflammatory response following craniotomy in patients.Methods: Forty five patients undergoing craniotomy were randomly divided into 3 groups: blank control group (group C), group DEXⅠ(The load and maintain quantity of DEX was 0.5 ug/kg and 0.5 ug/kg/h),group DEXⅡ(The load and maintain quantity of DEX was 1ug/kg and 1ug/kg/h).MMSE scores were determined 24 hours before and after operation in all patients. Serum IL-6, TNF-α levels were determined in radioimmunoassay at the point in time of T0(24 hours before operation),T1(endocranium was cuted),T2(the end of operation) and T3(24 hours postoperative). Results:1.DEX could improve MMSE scores early postoperative.2.DEX can reduce the concentration of serum IL – 6 and TNF-α, and the effect of group DEXⅡ was more apparent(p<0.05). Conclusions: Dexmedetomidine could decrease serum IL-6 and TNF-α levels in patients undergoing craniotomy, could reduce inflammatory response and improve the MMSE scores.
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