盐酸右美托咪啶对脑膜瘤患者围术期的脑保护效应

The cerebral protective effect of dexmedetomidine hydrochloride on perioperative patients with meningiomas

目的探讨右美托咪啶对脑膜瘤患者围术期的脑保护效应。方法择期行脑膜瘤切除术患者50例,随机分成对照组和盐酸右美托咪啶(DEX)组,分别检测2组手术前24h(T1)、切开硬脑膜后(T2)、手术结束时(T3)和手术后24h(T4)4个时间点的血清神经元特异性烯醇化酶(NSE)及白介素6(IL-6)水平并进行比较,比较2组围术期血清NSE及IL-6水平。结果 2组NSE、IL-6水平在T1无显著性差异,对照组T2、T3、T4的NSE水平均较T1均明显升高,DEX组在T3、T4的NSE水平较T1升高,DEX组血清NSE水平在T2、T3、T4的NSE水平均明显低于对照组,差异有统计学意义(P<0.05)。2组血清IL-6水平随着手术的进行逐渐升高,且在T3时达最高,对照组IL-6水平为(401.45±188.33)μg/L,DEX组为(167.36±53.03)μg/L,对照组T2、T3、T血清IL-6水平均明显高于T1水平,但DEX组仅在T3时明显高于T1,在T2、T4时IL-6水平与T1比较无显著性差异(P>0.05);DEX组IL-6水平在T2、T3、T4均明显低于对照组,差异有统计学意义(P均<0.05)。结论右美托咪啶对脑膜瘤手术患者具有一定的脑保护作用,其机制可能与降低围术期血清NSE和IL-6水平相关。

Objective To investigate the cerebral protective effect of dexmedetomidine hydrochloride on perioperative patients with meningiomas.Methods 50 meningioma patients were randomly divided into control group and dexmedetomidine hydrochloride（DEX）group.The serum level of neuron specific enolase（NSE）and interleukin 6（IL-6）of two groups were compared at 24-hour before operation（T1）,time after cutting the dura mater（T2）,at the end of surgery and 24 hours after operation（T4）.Results The NSE and IL-6levels of DEX group were significantly lower than these of control group,which hada significant difference（P〈0.05）.Conclusion Dexmedetomidine has a certain protective effect for patients with meningioma operation.The mechanism may be associated with the serum NSE and IL-6levels decreasing in perioperative period.