右美托咪定对老年高血压患者免疫功能及血流动力学参数的影响

Effects of dexmedetomidine on immune function and hemodynamic parameters in elderly patients with essential hypertension

分析右美托咪定对老年高血压患者免疫功能及血流动力学参数的影响,为临床合理应用提供参考。以本院行胃癌根治术合并高血压患者为研究对象。将80例患者按麻醉方法分为两组:对照组40例和右美托咪定组40例。两组患者均采用舒芬太尼、依托咪酯和罗库溴铵诱导麻醉,右美托咪定组患者诱导前15 min静脉持续泵入右美托咪定0.5μg/kg。分析两组患者免疫功能及血流动力学参数变化。结果显示:与对照组相比,右美托咪定组患者在拔管前、拔管时、拔管后5 min及拔管后10 min的平均动脉压(MAP)及心率(HR)均明显降低(P<0.05);右美托咪定组患者的拔管时间、免疫功能分子CD4和CD8及CD4/CD8水平与对照组无明显差异(P>0.05),而拉姆齐评分(Ramsay评分)明显升高、舒芬太尼泵入量明显减少(P<0.05)。因此,右美托咪定对老年高血压患者血流动力学参数及免疫功能有一定影响,需引起临床关注。

The aim of this study was to analyze the effects of dexmedetomidine on immune function and hemodynamic parameters in elderly patients with hypertension. The clinical data of patients undergoing radical gastrectomy combined with hypertension were retrospectively analyzed. 80 patients were randomly divided into two groups according to anesthesia: control group (n =40) and dexmedetomidine group (n =40). The two groups were anesthetized with sufentanil, etomidate, and rocuronium. The patients in the right metoimidin group were continuously pumped into right metoomidil 0. 5 g/ kg before induction in the right metoimidin group. The changes of immune function and hemodynamic parameters of the two groups were analyzed. Compared with the control group, the MAP and HR of 10min after extubation, 5min and extubation after extubation, extubation and extubation were significantly lower in right metoimidin group, and the difference was statistically significant (P<0. 05). There was no significant difference in extubation time, immune function molecules CD4+ and CD8+ and CD4+/ CD8+ levels between the dexmedetomidine group and the control group (P >0. 05). The Ramsay score of the dexmedetomidine group increased significantly, and the remifentanil infusion volume decreased significantly, and the difference was statistically significant (P <0. 05). Dexmedetomidine has certain effect on hemodynamic parameters in elderly patients with hypertension, which needs clinical attention.