0.5μg(kg·h)维持剂量右美托咪定麻醉对肺癌根治术患者血清IL-6、NSE、S100β蛋白水平的影响

Effects of 0.5 μg(kg·h) Dose of Dexmedetomidine on the serum IL-6, NSE and S100β Protein Levels of Patients with Lung Cancer Radical Surgery

目的:探讨肺癌根治术应用0.5μg(kg·h)维持剂量右美托咪定(Dex)辅助麻醉对患者血清白细胞介素-6(IL-6)、神经元特异性烯醇化酶(NES)及S100β蛋白水平的影响。方法:选取我院2016年3月~2017年3月收治并择期行肺癌根治术治疗的92例患者,采取随机数字表法均分为两组。所有患者均采取相同的常规静吸复合麻醉,于麻醉诱导前15 min(T_1)静脉滴注负荷剂量为1μg/kg的Dex。观察组在此基础上以0.5μg/(kg·h)速度持续静脉泵注Dex至术毕前10 min,对照组以等剂量生理盐水重复以上操作。记录比较两组T_1、单肺通气前(T_2)、单肺通气60 min(T_3)、术毕时刻(T_4)、术后24 h(T_5)血清IL-6、NSE、S100β蛋白水平及术后不良反应的发生情况。结果:与T_1时间点对比,两组T_2、T_3、T_4、T_5时血清IL-6、NSE、S100β水平均显著升高(P<0.01),且观察组在T_2、T_3、T_4、T_5时血清IL-6、S100β水平显著低于对照组同时(P<0.01)。观察组术后不良反应率较对照组低(P<0.05)。结论:肺癌根治术应用0.5μg(kg·h)维持剂量右美托咪定(Dex)辅助麻醉更能有效降低术患者IL-6、NSE、S100β蛋白水平,抑制机体炎症反应,减轻脑损伤,且安全性高。

Objective： To explore the effect of 0.5 μg（kg·h） maintenance dose of dexmedetomidine（Dex） on the serum interleukin IL-6（IL-6）, neuron-specific enolase（NSE） and S100β protein levels of patients with lung cancer radical surgery. Methods： 92 cases of patients undergoing elective resection of lung cancer treatment in our hospital from March 2016 to March 2017 were selected as research objectives and randomly divided into two groups. All cases were provided with the same conventional intravenous combined anesthesia, Dex was administered at a dose of 1 μg/kg intravenously at 15 min before induction of anesthesia（T1）. The observation group was given continuous intravenous injection of Dex at a rate of 0.5 μg（kg·h） till 10 mins before operation, the above procedure was re-peated with equal dose of saline to the control group. The serum IL-6, NSE, S100β levels at T1, before single lung ventilation（T2）, sin-gle lung ventilation（T3）, operation finished time（T4）, postoperative 24 h（T5） as well as the incidence of postoperative adverse reaction were compared between two groups. Results： The serum IL-6, NSE and S100β protein levels at T2, T3, T4, T5 were significant higher than those at T1（P〈0.01）, which were significantly lower in the observation group than those of the control group at same time points（P〈0.01）. The incidence of postoperative adverse reactions in observation group was significantly lower than that of the control group（P〈0.05）. Conclusion： 0.5 μg（kg·h） maintenance dose of Dex assisted anesthesia helps patient to reduce the serum IL-6, NSE, S100β protein level S inhibit the inflammatory response and reduce brain damage WITH high safely.