右美托咪啶对不停跳冠状动脉旁路移植术中高迁移率族蛋白1的影响

Effect of dexmedetomidine on high mobility group box-1 protein in off-pump cornary artery bypass

目的 观察右美托咪啶对不停跳冠状动脉旁路移植术中高迁移率族蛋白-1（HMGB-1）的影响.方法 将60例不停跳冠状动脉旁路移植术患者随机分为右美托咪啶组和对照组,均以咪达唑仑、舒芬太尼、维库溴铵行麻醉诱导,采用丙泊酚、舒芬太尼靶控输注,间断注射维库溴铵,维持脑电双频指数（BIS）为40-60.右美托咪啶组从诱导开始静脉泵入右美托咪啶0.5μg/（kg＆#183;h）进行维持麻醉,对照组同期给以等量生理盐水.于麻醉诱导后（T1）、吻合血管前（T2）、术后6 h（T3）、术后24 h（T4）、术后48 h（T5）5个时间点采血10 ml,进行HMGB-1 Western blot检测分析.结果 右美托咪啶组HMGB-1在T2、T3、T4、T5都明显低于对照组（T2：1.60 ±0.21比2.51 ±0.38,P＜0.01;T3：2.16±0.29比3.75±0.60,P＜0.01;T4：1.85 ±0.21比2.57±0.36,P＜0.01;T5：1.90 ±0.35比2.95 ±0.41,P＜0.01）.结论 右美托咪啶在不停跳冠状动脉旁路移植术中应用能够降低HMGB-1水平,发挥抗炎及免疫调节作用.

Objective To study the effect of dexmedetomidine on high mobility rate group protein 1 （HMGB-1） in off-pump cornary artery bypass.Methods The patients undergoing off-pump coronary artery bypass graft surgery were selected,and randomly divided into dexmedetomidine group （D group） and control group （C group）,n =30 each.Two sets were induced for anesthesia with midazolam,sufentanil,vecuronium,using target controlled infusion of propofol and sufentanil infusion,intermittent injection of vecuronium.Maintain bispectral index （BIS） in the range 40-60.Group D starts induced by filling the dexmedetomidine anesthesia was maintained with the microphone 0.5 μg/（kg＆#183;h）.After induction of anesthesia （T1）,before vascular anastomosis （T2）,6 h after operation （T3）,24 h after operation （T4）,48 h after operation （T5） 5 points respectively for blood 10 ml HMGB-1 Western blotting testing.Results Group D of HMGB-1 in T2,T3,T4,T5,were significantly lower than Group C in T2,T3,T4,T5（T2：1.60±0.21 vs.2.51 ± 0.38,P〈0.01;T3：2.16 ±0.29 vs.3.75 ± 0.60,P〈0.01;T4：1.85 ± 0.21 vs.2.57 ± 0.36,P〈0.01;T5：1.90 ± 0.35 vs.2.95 ± 0.41,P〈0.01）.Conclusion The application of dexmedetomidine can decrease the content of HMGB-1 in off-pump cornary artery bypass,exert its anti inflammation and immune regulation.