右美托咪定对脑膜瘤切除术患者血清S100β蛋白及神经元特异性烯醇化酶的影响

Effect of dexmedetomidine on serum S100β protein and NSE in patients undergoing meningioma operation

目的：研究负荷剂量右美托咪定对脑膜瘤切除术患者血清S100β蛋白、神经元特异性烯醇化酶（neuron-specific enolase,NSE）含量的影响并探讨其脑保护作用。方法：将40例择期行脑膜瘤切除术的患者随机分为右美托咪定组（D组）和对照组（C组）,每组各20例。D组患者于麻醉诱导前10 min静脉注射右美托咪定1μg/kg,20 min注射完毕;C组患者静脉泵注等容量生理盐水。记录患者术前和术后24 h的简易精神状态量表（mini-mental state examination,MMSE）评分。记录患者入室后（T_0）、诱导前即刻（T_1）、插管后1 min（T_2）、手术开始时（T_3）、切开硬脑膜时（T_4）、肿物切除时（T_5）、术毕时（T_6）的SBP、DBP及心率（HR）。分别于T0、T4、T6、术后24 h（T_7）抽取静脉血,测定血清中S100β蛋白、NSE的含量。结果：两组患者术后MMSE评分均低于术前（P〈0.05）。D组SBP、DBP、HR在T_1~T_6时较T0时明显降低（P〈0.05）,在T_2时明显低于C组（P〈0.05）。T_4、T_6时D组S100β蛋白含量明显低于C组（P〈0.05）。T_6时,D组NSE含量明显低于C组（P〈0.05）。结论：负荷剂量右美托咪定有利于维持脑膜瘤患者围术期血流动力学平稳,降低术中S100β蛋白、NSE的含量,具有一定的脑保护作用。

AIM：To evaluate the neuroprotective effect of load-dose dexmedetomidine （Dex） in patients undergoing meningioma operation.METHODS：Forty patients scheduled for meningioma operation were randomly divided into two groups：Dex group （group D,n =20） and control group （group C,n =20）.Dex was intravenously infused 10 min before induction at the dose of 1 μg/kg and finished in 20 min in group D.Patients in group C were given the same bolus of saline.The Mini-Mental State Examination （MMSE） scores of all patients at 24 h were recorded before and after operation.The SBP,DBP and HR of all patients were monitored after entering operation room （T0）,before induction （T1）,1 min after intubation （T2）,at the initiation of the surgery （T3）,after opening the dura mater （T4）,when the tumor was removed （T5）,at the end of the operation （T6）.Venous blood samples were taken for determination of neuron-specific enolase （NSE） and S100β protein at T0,T4,T6 and 24 hour after the operation （T7）.RESULTS：The postoperative MMSE scores were lower than before in two groups （P 〈 0.05）.Compared with T0,the SBP,DBP and HR in group D were significantly decreased at T1-T6 （P 〈 0.05）,and were different with group C at T2 （P 〈0.05）.The S100β3 protein levels were lower in group D than group C at T4 and T6 （P 〈 0.05）.At the point of T6,there was apparently difference between group D and group C.CONCLUSION：The postoperative MMSE scores were lower than before in two groups （P 〈 0.05）.Compared with T0,the SBP,DBP and HR in group D were significantly decreased at T1-T6 （P 〈 0.05）,and were different with group C at T2 （P 〈 0.05）.The S100β3 protein levels were lower in group D than group C at T4 and T6 （P 〈 0.05）.At the point of T6,there was apparently difference between group D and group C.