右美托咪定对颈动脉内膜剥脱术患者脑氧代谢、神经功能以及炎症反应的调节作用

Effect of dexmedetomidine on cerebral oxygen metabolism,nerve function and inflammation in patients with carotid endarterectomy

目的：分析右美托咪定对颈动脉内膜剥脱术患者脑氧代谢、神经功能以及炎症反应的调节作用。方法：将在本院接受颈动脉内膜剥脱术治疗的患者62例纳入研究,随机分为观察组及对照组各31例。对照组接受常规麻醉,观察组在术中使用右美托咪定,对比两组术中脑血管动力学指标、脑氧代谢指标、神经功能相关指标、炎症相关因子水平等差异。结果：观察组术后早期Vmean、Qmean值高于对照组,Wv、R、DP值低于对照组,差异具有统计学意义（P〈0.05）;CjvO2、COER、SjvO2值高于对照组,DajvO2值低于对照组,差异具有统计学意义（P〈0.05）;观察组术中血清ICAM-1、IL-13、TGF-β、IL-17A、ET、NF-κB值均低于对照组,差异具有统计学意义（P〈0.05）。结论：颈动脉内膜剥脱术患者术中使用右美托咪定,可以有效发挥脑保护作用,降低脑氧代谢及全身炎症反应,具有积极的临床意义。

Objective：To analyze the regulating effects of dexmedetomidine on cerebral oxygen metabolism,nerve function and inflammation in patients with carotid endarterectomy.Methods：A total of 62 patients underwent carotid endarterectomy in our hospital were included for study and randomly divided into observation group（n=31cases）and control group（n=31cases）.Control group received conventional anesthesia,observation group received dexmedetomidine during operation,and then differences in levels of intraoperative cerebrovascular hemodynamic indicators,cerebral oxygen metabolism indicators,nerve function-related indicators,inflammation-related indicators and so on were compared between two groups.Results：Early postoperative Vmean and Qmean values of observation group were higher than those of control group,and Wv,R and DP values were lower than those of control group（P〈0.05）;CjvO2,COER and SjvO2 values were higher than those of control group,and Da-jvO2 value was lower than that of control group（P〈0.05）;intraoperative serum ICAM-1,IL-13,TGF-β,IL-17 A,ET and NF-κB values of observation group were lower than those of control group（P〈0.05）.Conclusion：Intraoperative application of dexmedetomidine for patients with carotid endarterectomy can effectively protect the brain and reduce cerebral oxygen metabolism and systemic inflammation,and it has active clinical significance.