盐酸右美托咪定对单肺通气时炎性反应及氧化应激反应的影响

Dexmedetomidine Hydrochloride effects on Inflammatory and Oxidative Stress Responses During one Lung Ventilation

目的探讨盐酸右美托咪定对单肺通气时炎性反应及氧化应激反应的影响。方法收集2013年9月至2014年9月我院收治的择期行食管癌根治术的50例患者资料,随机分为观察组和对照组,各25例。观察组患者于气管插管后10 min按1μg/kg静脉输注盐酸右美托咪定,10 min后按0.5μg/(kg·h)持续输注至关胸;对照组患者给予静脉滴注等容量0.9%氯化钠注射液。于单肺通气开始即刻(T0)、单肺通气后60 min(T1)和术毕(T2)采集肘静脉血,检测两组患者不同时点的肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、血清丙二醛(MDA)和超氧化物歧化酶(SOD)的浓度或水平。结果两组患者T2时的TNF-α、IL-6、MDA浓度均明显高于T0时,血清SOD活性低于T0,差异均有统计学意义(均P<0.05);观察组患者T2时的TNF-α、IL-6、MDA浓度均明显低于对照组,血清SOD活性高于对照组,差异均有统计学意义(均P<0.05)。结论盐酸右美托咪定可抑制单肺通气时肺组织的炎性反应,降低其氧化应激程度,进而发挥肺保护作用。

Objective To investigate the effect of dexmedetomidine hydrochloride on inflammatory and oxidative stress responses during one lung ventilation.Methods 50 patients undergoing radical resection of esophageal cancer patients from 2013 September to 2014 September in our hospital patients,randomly divided into observation group and control group,each of 25 cases.The patients in study group after tracheal intubation,10 min in 1 g/kg intravenous infusion of dexmedetomidine hydrochloride,10 min after 0.5 g/（kg·H）continuous infusion is chest;patients in control group were treated with intravenous injection of equal volume of 0.9%Sodium Chloride Injection.Begin immediately to one lung ventilation（T0）,60 min after one lung ventilation（T1）and the end of operation（T2）col ected venous blood,tumor necrosis factor alpha detection of two groups of patients with time points（TNF-a）,interleukin 6（IL-6）,serum malondialdehyde（MDA）and super oxide dismutase（SOD）concentration or level.Results Two groups of patients with T2 TNF-a,IL-6,MDA concentrations were significantly higher than the T0,the SOD activity in serum is lower than T0,the difference was statistical y significant（P〈0.05）;patients in the observation group T2 TNF-a,IL-6,MDA concentrations were significantly lower than the control group,the serum SOD activity is higher than that of the control group,the differences were there statistical significance（P〈0.05）.Conclusion Dexmedetomidine hydrochloride may inhibit the inflammatory response in lung tissue during one lung ventilation,reduce the degree of oxidative stress,and then play the lung protective effect.