右美托咪定对急性脑损伤患者血清NSE、S-100β、内脂素的影响

Effect of dexmedetomidine on serum NSE,S-100β,visfatin in patients with acute brain injury

目的：探讨右美托咪定对急性脑损伤患者血清神经元特异性烯醇化酶（NSE）、S-100β、内脂素的影响。方法：将76例急性脑损伤患者按照麻醉方式的不同分为研究组（n=36）和对照组（n=40）。全部患者行开颅术及血肿清除术,采用全身复合麻醉。麻醉诱导前,研究组静脉泵注右美托咪定,对照组给予等量的生理盐水。于入室后（T_0）、手术60 min（T_1）、手术结束（T_2）、术后24 h（T_3）、术后3 d（T_4）、术后5 d（T_5）,检测两组血清内脂素、超敏C反应蛋白（hs-CRP）、NSE、S-100β水平变化。随访6个月,采用格拉斯哥预后量表（GCS）评估患者预后情况。结果：两组内脂素、hs-CRP在T2～T5时的水平显著高于同组在T_0时的水平,差异有统计学意义（P〈0.05）;在T_3～T_5时,研究组内脂素、hs-CRP显著高于对照组,差异有统计学意义（P〈0.05）;两组NSE、S-100β在T_1～T_5时的水平显著高于同组在T_0时的水平,差异有统计学意义（P〈0.05）;在T_3～T_5时,研究组NSE、S-100β显著高于对照组,差异有统计学意义（P〈0.05）;随访6个月后,研究组的预后显著优于对照组,差异有统计学意义（P〈0.05）。结论：右美托咪定用于急性脑损伤患者手术麻醉,有助于减轻炎症反应,降低脑组织损伤,改善患者预后。

AIM： To investigate the effect of dexmedetomidine on serum neuron specific enolase （NSE）, S-100β, visfatin in patients with acute brain injury. METHODS： 76 cases of acute brain injury were divided into study group （n = 36） and control group （n = 40 ） according to the different ways of anesthesia. Craniotomy and evacuation of hematoma under general anesthesia were performed on all patients. Before induction of anesthesia, the study group was infused with dexmedetomidine intra- venously, while the control group was given saline of equal amount. Levels of visfatin, hs-CRP, NSE, S- 100β were detected before surgery （To）, 60 mi- nutes after the operation （ T1 ）, the end of operation （T2）, 24 hours after operation （T3）, 3 days after the operation （T4 ）, 5 days after surgery （T5 ） in the two groups. Follow-up was conducted 6 months lat- er; prognosis of patients was assessed by the Glas- gow Outcome Scale （GOS）. RESULTS：Levels of lipid and hs-CRP in two groups were significantly higher than those in the same group at the time of T2-T5 （P 〈 0.05 ）. In T3-T5, the research group, hs-CRP was significantly higher than the control group （P〈0.05）. The level of NSE and S-100 in the two groups was significantly higher than that in the same group at the time of T1-T5 （ P 〈 0.05 ）. At T3-T5, NSE and S-100β in the study group were sig- nificantly higher than those in the control group （P 〈 0.05 ）. After 6 months follow-up, the prognosis of the study group was significantly better than that of the control group （P 〈 0.05）. CONCLUSION： Dexmedetomidine helps to reduce inflammation, reduce brain injury and improve the prognosis of patients with acute brain injury.