目的评价右美托咪定对新辅助化疗结肠癌患者术后认知功能障碍(POCD)的影响。方法选取2020年6月至2021年12月深圳市人民医院择期行结肠癌根治术患者105例为研究对象,采用随机数字表法分对照组、新辅助化疗组和右美托咪定治疗组,每组35例...目的评价右美托咪定对新辅助化疗结肠癌患者术后认知功能障碍(POCD)的影响。方法选取2020年6月至2021年12月深圳市人民医院择期行结肠癌根治术患者105例为研究对象,采用随机数字表法分对照组、新辅助化疗组和右美托咪定治疗组,每组35例。对照组术前未接受新辅助化疗,新辅助化疗组和右美托咪定治疗组术前均接受新辅助化疗。右美托咪定治疗组麻醉诱导前给予0.5μg/kg负荷量的右美托咪定,给药时间为15 min,随即持续输注0.5μg/(kg·h)右美托咪定,术毕前30 min停止输注。分别于术前1 d、术后1、3 d检测3组患者血液中TNF-α、IL-17、丙二醛(MDA)、S-100β水平及超氧化物歧化酶(SOD)活性。于术前1 d和术后7 d记录3组患者简易精神状态量表(MMSE)、数字符号替换测试(DSST)、数字广度(顺向)及数字广度(反向)测试的评分并计算POCD发生率。结果与对照组比较,新辅助化疗组患者术后1、3 d血液中TNF-α、IL-17、MDA、S-100β水平均升高,SOD活性均降低,术后7 d MMSE、DSST、数字广度(顺向)和数字广度(反向)测试评分均降低,术后7 d POCD发生率增加,差异均有统计学意义(均P<0.05);与新辅助化疗组比较,右美托咪定治疗组患者术后1、3 d血液中TNF-α、IL-17、MDA、S-100β水平均降低,SOD活性均升高,术后7 d MMSE、DSST、数字广度(顺向)和数字广度(反向)测试评分均升高,术后7 d POCD发生率降低,差异均有统计学意义(均P<0.05)。结论术前新辅助化疗导致结肠癌手术患者POCD发生率增加,而右美托咪定治疗可降低这些患者POCD发生率,其机制可能与其抑制炎性反应和氧化反应有关。展开更多
This study aims to elucidate the mechanisms by which dexmedetomidine alleviates pulmonary edema in rats with acute lung injury induced by lipopolysaccharide （LPS）. Male Wistar rats were randomly divided into five gr...This study aims to elucidate the mechanisms by which dexmedetomidine alleviates pulmonary edema in rats with acute lung injury induced by lipopolysaccharide （LPS）. Male Wistar rats were randomly divided into five groups： normal saline control （NS） group, receiving intravenous 0.9% normal saline （5 mL/kg）; LPS group, receiving intravenous LPS （10 mg/kg）; small-dose dexmedetomidine （S） group, treated with a small dose of dexmedetomidine （0.5 μg·kg^-1·h^-1）; medium-dose dexmedetomidine （M） group, treated with a medium dose of dexmedetomidine （2.5 μg·kg^-1·h^-1）; high-dose dexmedetomidine （H） group, treated with a high dose of dexmedetomidine （5μg·kg^-1·h^-1）. The rats were sacrificed 6 h after intravenous injection of LPS or NS, and the hmgs were removed for evaluating histological characteristics and determining the lung wet/dry weight ratio （W/D）. The levels of tumor necrosis factor-alpha （TNF-α） and interleukin-1β （IL-1β） in the lung tissues were assessed by enzyme-linked immunosorbent assay （ELISA）. The mRNA and protein expression levels of aquaporin-1 （AQP1） and aquaporin-5 （AQP5） were detected by RT-PCR, immunohistochemistry, and Western blot- ting. The lung tissues from the LPS groups were significantly damaged, which were less pronounced in the H group but not in the small-dose dexmedetomidine group or medium-dose dexmedetomidine group. The W/D and the concentrations of TNF-α and IL-1β in the pulmonary tissues were increased in the LPS group as compared with those in NS group, which were reduced in the H group but not in S group or M group （P〈0.01）. The expression of AQP1 and AQP5 was lower in the LPS group than in the NS group, and significantly increased in the H group but not in the S group or M group （P〈0.01）. Our findings suggest that dexmedetomidine may alleviate pulmonary edema by increasing the expression of AQP-1 and AQP-5.展开更多
文摘目的评价右美托咪定对新辅助化疗结肠癌患者术后认知功能障碍(POCD)的影响。方法选取2020年6月至2021年12月深圳市人民医院择期行结肠癌根治术患者105例为研究对象,采用随机数字表法分对照组、新辅助化疗组和右美托咪定治疗组,每组35例。对照组术前未接受新辅助化疗,新辅助化疗组和右美托咪定治疗组术前均接受新辅助化疗。右美托咪定治疗组麻醉诱导前给予0.5μg/kg负荷量的右美托咪定,给药时间为15 min,随即持续输注0.5μg/(kg·h)右美托咪定,术毕前30 min停止输注。分别于术前1 d、术后1、3 d检测3组患者血液中TNF-α、IL-17、丙二醛(MDA)、S-100β水平及超氧化物歧化酶(SOD)活性。于术前1 d和术后7 d记录3组患者简易精神状态量表(MMSE)、数字符号替换测试(DSST)、数字广度(顺向)及数字广度(反向)测试的评分并计算POCD发生率。结果与对照组比较,新辅助化疗组患者术后1、3 d血液中TNF-α、IL-17、MDA、S-100β水平均升高,SOD活性均降低,术后7 d MMSE、DSST、数字广度(顺向)和数字广度(反向)测试评分均降低,术后7 d POCD发生率增加,差异均有统计学意义(均P<0.05);与新辅助化疗组比较,右美托咪定治疗组患者术后1、3 d血液中TNF-α、IL-17、MDA、S-100β水平均降低,SOD活性均升高,术后7 d MMSE、DSST、数字广度(顺向)和数字广度(反向)测试评分均升高,术后7 d POCD发生率降低,差异均有统计学意义(均P<0.05)。结论术前新辅助化疗导致结肠癌手术患者POCD发生率增加,而右美托咪定治疗可降低这些患者POCD发生率,其机制可能与其抑制炎性反应和氧化反应有关。
基金supported by a grant from Technical Research and Development Fund of Shenzhen(No.JCYJ20140416122812032)
文摘This study aims to elucidate the mechanisms by which dexmedetomidine alleviates pulmonary edema in rats with acute lung injury induced by lipopolysaccharide （LPS）. Male Wistar rats were randomly divided into five groups： normal saline control （NS） group, receiving intravenous 0.9% normal saline （5 mL/kg）; LPS group, receiving intravenous LPS （10 mg/kg）; small-dose dexmedetomidine （S） group, treated with a small dose of dexmedetomidine （0.5 μg·kg^-1·h^-1）; medium-dose dexmedetomidine （M） group, treated with a medium dose of dexmedetomidine （2.5 μg·kg^-1·h^-1）; high-dose dexmedetomidine （H） group, treated with a high dose of dexmedetomidine （5μg·kg^-1·h^-1）. The rats were sacrificed 6 h after intravenous injection of LPS or NS, and the hmgs were removed for evaluating histological characteristics and determining the lung wet/dry weight ratio （W/D）. The levels of tumor necrosis factor-alpha （TNF-α） and interleukin-1β （IL-1β） in the lung tissues were assessed by enzyme-linked immunosorbent assay （ELISA）. The mRNA and protein expression levels of aquaporin-1 （AQP1） and aquaporin-5 （AQP5） were detected by RT-PCR, immunohistochemistry, and Western blot- ting. The lung tissues from the LPS groups were significantly damaged, which were less pronounced in the H group but not in the small-dose dexmedetomidine group or medium-dose dexmedetomidine group. The W/D and the concentrations of TNF-α and IL-1β in the pulmonary tissues were increased in the LPS group as compared with those in NS group, which were reduced in the H group but not in S group or M group （P〈0.01）. The expression of AQP1 and AQP5 was lower in the LPS group than in the NS group, and significantly increased in the H group but not in the S group or M group （P〈0.01）. Our findings suggest that dexmedetomidine may alleviate pulmonary edema by increasing the expression of AQP-1 and AQP-5.
