不同浓度右美托咪啶对小儿麻醉后血清肌钙蛋白I、C反应蛋白以及补体水平的影响

Effect of Different Concentrations of Dexmedetomidine on the Serum CRP,Troponin I and Complement Levels of Children after Anesthesia

目的:探讨不同浓度右美托咪啶对小儿麻醉后血清肌钙蛋白I、C反应蛋白(CRP)及补体水平的影响。方法:选取我院收治的拟行手术的患儿60例,根据应用右美托咪定的浓度随机分为A、B、C三组,每组各20例。A、B组患儿予右美托咪啶0.5、0.25μg/kg的负荷剂量静脉推注给药10分钟,然后以0.2-0.7μg/kg/h的速度持续静脉微量泵入维持患者镇静状态,C组直接以右美托咪啶0.2-0.7μg/kg/h的速度持续泵入维持镇静状态。比较三组患儿麻醉术后的苏醒情况,麻醉前后不同时点血清肌钙蛋白I、C反应蛋白及补体水平的变化。结果:治疗前,三组患儿的各项指标比较均无统计学差异(P>0.05);治疗后,与A、C两组比较,B组患者自主呼吸恢复时间、气管导管拔管时间、解除监护时间显著缩短(P<0.05),术后24、72 h血清CRP水平更低,术后1、6、24 h血清肌钙蛋白I水平较低(P<0.05),术后1、24、72 h血清补体水平较高(P<0.05)。结论:0.25μg/kg浓度的右美托咪啶对于对小儿麻醉后血清肌钙蛋白I、C反应蛋白及补体水平的影响明显,且有助于患儿术后的苏醒。

Objective： To investigate the effects of different concentrations of dexmedetomidine on the serum CRP, troponin I and complement levels of children after anesthesia. Methods： 60 patients undergoing operation in our hospital were selected and randomly di- vided into three groups according to the application of different concentrations of dexmedetomidine, 20 cases in each group. Children in group A and B were given 0.5, 0.25 ixg/kg dexmedetomidine through intravenous injection for 10 min, and then were maintained by dexmedetomidine at 0.2-0.7 μg/kg/h through continuous intravenous trace pumping, while children in group C were given dexmedeto- midine at 0.2-0.7 μg/kg/h through continuous intravenous trace pumping alone. The analepsia time, serum CRP, troponin I and comple- ment levels of children at different time points before and after anesthesia were compared between three groups. Results： Before treat- ment, no significant difference was found in the different indicators between three groups （P〉0.05）. After treatment, comprared with group A and group C, the spontaneous breathing recovery time, tracheal extubation time, lift the monitoring time of children in group B were all significantly shorter （P〈0.05）, the seruna CRP levels at 24, 72 h after operation were significantly lower, the cardiac troponin I levels at 1, 6 24 h after operation were also significantly lower （P〈0.05）, while the serum complement levels at 1, 24,72 h after operation were obviously higher（P〈0.05）. Conclusions： 0.25 μg/kg dexmedetomidine had obvious effect on the serum cardiac troponin I, C reactive protein and complement levels of children after anesthesia, and could promote the analepsia of children.