右美托咪定对老年心脏瓣膜置换术患者心肌保护和脑保护的影响

Clinical Effect of Dexmedetomidine in the Myocardial Protection and Cerebral Protection during the Heart Valve Replacement

目的探讨老年心脏瓣膜置换术中应用右美托咪定的效果。方法整群选取68例于2014年5月—2015年5月期间在该院行心脏瓣膜置换术的患者,随机将入选者分为A(右美托咪定)和B组(静注等量生理盐水),均行心脏瓣膜置换术。结果 A组T5、T6、T7、T8时c TnⅠ、H-FABP均低于B组(P<0.05),CK-MB于T6、T7、T8时较B组显著要低(P<0.05);两组NSE、S-100β蛋白在T3、T4、T6时均升高,而A组升高幅度低于B组(P<0.05);两组Sjv O2在T3时显著升高,T4时下降,A组明显高于B组(P<0.05),而Ca-jv O2在T3时均显著下降,于T4时上升,A组低于B组(P<0.05);两组在T3、T4时,ERO2均显著降低,Pa O2均明显升高,在T4时,A组ERO2低于B组,Pa O2高于B组(P<0.05)。结论在老年心脏瓣膜置换术中应用右美托咪定具有一定脑保护、心肌保护作用,具有推广价值。

Objective To study the clinical effect of Dexmedetomidine in elderly patients of adopting the heart valve replacement.Methods Group selection 68 elderly patients of adopting the heart valve replacement from May 2014 to May2015 in our hospital were selected.The subjects were randomly divided into two groups.During the heart valve replacement,Group A took Dexmedetomidine and Group B took the intravenous injection of normal saline.Results At T5,T6,T7,T8,the index of c TnⅠand H-FABP for Group A was lower than Group B（P〈0.05）;at T6,T7,T8,the index of CK-MB for Group A was lower than Group B（P〈0.05）;at T3,T4,T6,the index of NSE and S-100β for two groups was increased;the index for Group A was lower than Group B（P〈0.05）;at T3,the index of Sjv O2 was increased;at T4,the index of Sjv O2 was reduced;the index of Group A was higher than Group B（P〈0.05）;at T3,the index of Ca-jv O2 was reduced;at T4,the index of Ca-jv O2 was increased;the index of Group A was lower than Group B（P〈0.05）;at T3,T4,the index of ERO2 was reduced and the index of Pa O2 was increased;at T4,the index of ERO2 for Group A was lower than Group B;the index of Pa O2 for Group A was higher than Group B（P〈0.05）.Conclusion During the heart valve replacement,Dexmedetomidine has a certain effect in the myocardial protection and cerebral protection.It is worthy of promotion.