右美托咪定对全髋置换术患者血清TNF―αIL―6和IL―1β影响.docVIP

右美托咪定对全髋置换术患者血清TNF―αIL―6和IL―1β影响 　　[摘要] 目的 观察右美托咪定对全髋置换术患者血清肿瘤坏死因子（TNF-α）、白细胞介素-6（interleukin-6，IL-6）和白细胞介素-1β（IL-1β）的影响。 方法 将60例ASAⅠ～Ⅱ级、行全髋置换术的患者随机分为右美托咪定组（D组）和对照组（C组），每组30例。所有患者均采用硬膜外麻醉，D组患者以剂量为0.6 μg/kg的右美托咪定，C组则给予等容量的生理盐水于手术开始即刻15 min内静脉持续恒速泵注输入。分别于麻醉前（T0）、手术开始后30 min（T1）、术毕即刻（T2）、术后6 h（T3）、术后12 h（T4）以及术后24 h（T5） 抽外周静脉血3 mL，测定血清TNF-α、IL-6和IL-1β水平。 结果 与T0比较，两组患者T1、T2、T3、T4、T5时点血清TNF-α、IL-6和IL-1β的浓度明显升高（P0.05）。D组T1、T2、T3、T4、T5时点血清TNF-α、IL-6和IL-1β的浓度明显低于C组（P0.05）。 结论 右美托咪定能减少全髋置换术患者围术期血清炎症因子TNF-α、IL-6和IL-1β的水平，对抑制手术引起的过度炎症反应有一定意义。 　　[关键词] 右美托咪定；炎症因子；全髋置换术 　　[中图分类号] R687.4 [文献标识码] A [文章编号] 1673-9701（2014）11-0004-03 　　[Abstract] Objective To investigate the effect of dexmedetomidine on serum TNF-α， IL-6 and IL-1β in patients undergoing total hip replacement. Methods Sixty patients ASAⅠ-Ⅱ underwent total hip replacement were allocated randomly divided into dexmedetomidine group （Group D， n=30） and control group（Group C， n=30）. Patients in Group D were treated with dexmedetomidin and in Group C untreated， receivied dexmedetomidine 0.6 μg/kg and saline vehicle respectively in the beginning 15 min of surgery. The levels of TNF-α， IL-6 and IL-1β in serum ere detected before anesthesia （T0）， 30 min after pneumoperitoneum （T1）， the end of the operation （T2），6h （T3），12 h （T4） and 24 h after the end of surgery（T5）. Results The levels of TNF-α， IL-6 and IL-1β in serum were increased significantly at T1，T2，T3，T4 and T5 as compared with baseline values at T0 in both groups（P0.05）. Compared with Group C， the levels of TNF-α， IL-6 and IL-1β in serum were decreased significantly in Group D at T1，T2，T3，T4 and T5（P0.05）. Conclusion Dexmedetomidine can decrease the level of TNF-α， IL-6 and IL-1β in serum of patients undergone total hip replacement. This may inhibit excessive inflammation response of patients underwent total hip replacement. 　　[Key words] Dexmedetomidine；Inflammatory factor；Total hip replacement 　　盐酸右美托咪定（dexmedetomidine，Dex）有镇静、镇痛和抗焦虑、抗交感、降低应激反应、稳定血流动力学的作用[1]，对