右美托咪定对老年患者术后恢复期的心肌保护

Effects of Dexmedetomidine on Recovery of Myocardial Protection in Elderly Patients After Surgery

目的探讨右美托咪定对老年患者术后恢复期的心肌保护效应。方法随机选取该院2013年3月—2015年3月择期腹部手术的老年患者80例,随机分为两组(n=40):对照组(C组)和右美托咪定组(D组)。术毕转入重症监护室(ICU),D组静脉注射右美托咪定0.5 ug/kg作为负荷剂量,然后以0.3 ug/(kg·h)维持至拔出气管导管;C组给予等容量的生理盐水。记录MAP和HR变化,分析心型脂肪酸结合蛋白(H-FABP)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(c Tn I)的浓度变化。结果使用右美托咪定后D组HR明显减慢,MAP明显降低,与C组比较,差异有统计学意义(P<0.05)。与C组比较,D组血清HFABP、CK-MB、c Tn I浓度明显降低(P<0.05)。结论术后恢复期给予0.5 ug/kg负荷剂量的右美托咪定,随后以0.3 ug/(kg·h)持续静脉泵注,可减少老年患者血流动力学波动,降低心肌损伤,产生心肌保护效应。

Objective To investigate the effect of dexmedetomidine on recovery of myocardial protective effect of aged patients.Methods 80 elderly patients undergoing elective abdominal surgery were randomly divided into two groups(n=40): control group(group C) and dexmedetomidine group(group D). Postoperative intensive care unit(ICU), group D intravenous dexmedetomidine0.5 ug/kg as loading dose, and then to 0.3 ug/(kg·h) to pull out the endotracheal tube; C group received the same volume of saline. Record MAP and HR changes, analysis of heart type fatty acid binding protein(H-FABP), creatine kinase isoenzyme(CKMB), cardiac troponin I(c Tn I) concentration. Results The use of dexmedetomidine group D HR decreased significantly, MAP decreased significantly, compared with the C group, the difference was statistically significant(P < 0.05). Compared with C group, D group, serum H-FABP, CK-MB, c Tn I concentrations were significantly decreased(P < 0.05). Conclusion Postoperative recovery for0.5 ug/kg loading dose of dexmedetomidine 0.3 ug/(kg·h), followed by continuous intravenous infusion in elderly patients, can reduce the fluctuation of hemodynamics, reduce myocardial injury, resulting in myocardial protection effect.