丙泊酚联合右美托咪定治疗脑缺血再灌注损伤患者的临床研究

Clinical trial of propofol combined with dexmedetomidine in the treatment of patients with cerebral ischemia reperfusion injury

目的研究丙泊酚联合右美托咪定对脑缺血再灌注损伤患者的神经保护作用。方法将90例我院神经外科治疗的脑缺血再灌注损伤患者随机分为对照组和试验组,每组45例。对照组给予丙泊酚8 mg·kg^-1,静脉滴注;试验组在对照组的基础上给予右美托咪定4μg·mL^-1,静脉注射,2组均连续治疗14 d。比较2组患者治疗前后丙二醛(MDA)、超氧化物歧化酶(SOD)、炎性因子、脑源性神经营养因子(BDNF)水平及美国国立卫生研究院神经功能缺损评分(NIHSS)。结果治疗后,试验组和对照组MDA分别为(2.29±0.04),(4.49±1.02)nmoL·L^-1,SOD分别为(78.08±9.36),(50.48±5.38)U·mL^-1;肿瘤坏死因子-α(TNF-α)分别为(45.19±8.78),(58.18±9.38)ng·mL^-1,白细胞介素-6(IL-6)分别为(46.51±13.46),(58.79±13.01)ng·mL^-1;BDNF分别为(3.01±0.97),(2.29±0.68)ng·mL^-1,神经功能缺损评分分别为(2.38±1.36),(3.35±1.72)分;2组以上各指标差异均有统计学意义(均P<0.05)。结论丙泊酚联合右美托咪定可以改善脑缺血再灌注损伤患者机体SOD、MDA、炎性因子、BDNF水平,缓解神经炎症反应,减少神经损伤,起到神经保护的作用。

Objective To investigate the neuroprotective effect of propofol combined with dexmedetomidine in the treatment of patients with cerebral ischemia reperfusion injury.Methods Ninety patients with cerebral ischemia reperfusion injury were randomly divided into control group and treatment group,with 45 patients in each group.Patients in control group were given propofol 8 mg·kg^-1,intravenous drip;patients in treatment group were given dexmedetomidine 4μg·mL^-1,intravenous drip on the basis of control group.Both groups were treated for 14 d.The levels of superoxide dismutase(SOD),malondialdehyde(MDA),inflammatory factors,brain derived neurotrophic factor(BDNF)and National Institute of Health stroke scale(NIHSS)in two groups were detected before and after treatment in two groups.Results After treatment,the MDA in treatment group and control group were(2.29±0.04),(4.49±1.02)nmoL·L^-1,SOD were(78.08±9.36),(50.48±5.38)U·mL^-1;tumor necrosis factor-α(TNF-α)were(45.19±8.78),(58.18±9.38)ng·mL^-1,interleukin-6(IL-6)were(46.51±13.46),(58.79±13.01)ng·m L^-1;BDNF were(3.01±0.97),(2.29±0.68)ng·m L^-1,the NIHSS were 2.38±1.36,3.35±1.72;all with statistical difference(all P<0.05).Conclusion Propofol combined with dexmedetomidine can improve the levels of SOD,MDA,inflammatory factors and BDNF in patients with cerebral ischemia reperfusion injury,and alleviate the inflammatory reaction of nerve,reduce nerve injury and protect neuroprotection.