右美托咪啶与丙泊酚在心脏瓣膜手术对脑氧代谢影响的比较被引量：1

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摘要目的比较右美托咪啶与丙泊酚在心脏瓣膜手术对脑氧代谢的影响。方法选择2014年7月~2016年7月我院收治的浅低温体外循环下二尖瓣置换病人60例,随机分为丙泊酚组(P组)和右美托咪定组(D组),每组30例。P组静脉输注丙泊酚,D组静脉输注右美托咪定,比较不同时段颈内静脉球部血氧含量(Cjv O2)、脑动-静脉血氧含量差(Ca-jv DO2)、脑氧耗量(CMRO2)。结果与T1时比较,两组T2-T3时Cjv O2升高,Ca-jv DO2、CMRO2降低,差异有统计学意义(P<0.05),两组在T1,T2,T5中Cjv O2、Ca-jv DO2、CMRO2数据差异无统计学意义(P>0.05),D组在T3-T4 Cjv O2明显高于P组,Ca-jv DO2,CMRO2比P组明显低,差异有统计学意义(P<0.05)。结论右美托咪定在心脏瓣膜手术中复温时期降低脑氧耗减少脑损伤优于丙泊酚。但是两者对脑氧代谢影响的机制有待进一步的研究。

作者练胜强郑思屏纪浩聪

机构地区广东省惠州市第一人民医院麻醉科

出处《海峡药学》 2017年第7期202-204,共3页 Strait Pharmaceutical Journal

关键词丙泊酚右美托咪定体外循环脑代谢脑保护

分类号 R969.4 [医药卫生—药理学]

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1边卫,寇党培,韩建阁.右美托咪啶对体外循环心内直视手术患者脑氧代谢和糖代谢的影响[J].中华麻醉学杂志,2011,31(11):1293-1295. 被引量：16
2康芳,李娟,马骏,柴小青,潘建辉.右美托咪定对体外循环下心脏瓣膜置换术患者脑损伤的影响[J].中华麻醉学杂志,2012,32(12):1457-1459. 被引量：26
3任长和,欧册华.右美托咪啶脑保护作用的研究进展[J].医学综述,2012,18(5):721-723. 被引量：16

二级参考文献37

1Kocoglu H,Karaaslan K,Gonca E,et al.Preconditioning effects of dexmede-tomidine on myocardial ischemia/reperfusion injury in rats[J].Curr Ther Res Clin Exp,2008,69(2):150-158.
2Coursin DB,Coursin DB,Maccioli GA.Dexmedetomidine[J].Curr Opin Crit Care,2001,7(4):221-226.
3Dahmani S,Rouelle D,Gressens P,et al.Effects of dexmedetomidine on hippocampal focal adhesion kinase tyrosine phosphorylation in physiologic and ischemic conditions[J].Anesthesiology,2005,103(5):969-977.
4Huang R,Chen Y,Yu AC,et al.Dexmedetomidine induced stimulation of glutamine oxidation in astrocytes:a possible mechanism for its neuroprotective activity[J].J Cerebr Blood Flow Metab,2000,20(6):895-898.
5Engelhard K,Wemer C,Eberspacher E,et al.The effect of the alpha 2-agonist dexmedetomidine and the N-methyl-D-aspartate antagonist S(+)-ketamine on the expression of apoptosis-regulating proteins after incomplete cerebral ischemia and reperfusion in rats[J].Anesth Analg,2003,96(2):524-531.
6Sanders RD,Xu J,Shu Y,et al.Dexmedetomidine attenuates isoflurane-induced neurocognitive impairment in neonatal rats[J].Anesthesiology,2009,110(5):1077-1085.
7Dahmani S,Paris A,Jannier V,et al.Dexmedetomidine increases hippo-campal phosphorylated extracellular signal-regulated protein kinase 1 and 2 content by an alpha 2-adrenoceptor-independent mechanism:evidence for the involvement of imidazoline Ⅱ receptors[J].Anesthesiology,2008,108(3):457-466.
8Dahmani S,Rouelle D,Gressens P,et al.Characterization of the postco-nditioning effect of dexmedetomidine in mouse organotypic hippocampal slice cultures exposed to oxygen and glucose deprivation[J].Anesthesiology,2010,112(2):373-383.
9Tanabe K,Takai S,Matsushima-Nishiwaki R,et al.Alpha2 adrenoreeeptor agonist regulates protein kinase C-induced heat shock protein 27 phosphorylation in C6 glioma cells[J].J Neuroehem,2008,106(2):519-528.
10Kumagai M,Horiguchi T,Nishikawa T,et al.Intravenous dexmedetomidine decreases lung permeability induced by intracranial hypertension in rats[J].Anesth Analg,2008,107(2):643-647.