右美托咪定对30例体外循环患者肠道屏障损伤的影响

doi:10.6040/j.issn.1671-7554.0.2022.0296

摘要/Abstract

摘要： 目的探讨右美托咪定(DEX)对体外循环患者肠道屏障损伤的影响。方法将60例行体外循环心脏手术患者随机分为DEX组和对照组,每组30例。DEX组给予DEX干预,对照组给予等容量生理盐水输注。每组于给药前(T0)、体外循环结束即刻(T1)、术后2 h(T2)、术后6 h(T3)、术后24 h(T4)采集静脉血,测定肠型脂肪酸结合蛋白(I-FABP)、内毒素(LPS)、白介素-6(IL-6)及白介素-10(IL-10)浓度。并记录两组患者术后首次排便时间、重症监护室驻留时间、住院时间、死亡率以及不良反应的发生。结果 60例患者均完成了研究方案,未观察到死亡或严重并发症。同一组不同时间点血清I-FABP、LPS、IL-6、IL-10浓度差异具有统计学意义(P均<0.001),T1~T4点均较T0点高。两组间血清I-FABP、LPS、IL-6、IL-10浓度差异具有统计学意义(P=0.029;P=0.002;P=0.022;P=0.022);DEX组T1~T4点I-FABP、LPS、IL-6较对照组低,IL-10水平较对照组高。两组患者术后第一次排便时间、ICU驻留时间、住院时间差异无统计学意义(P均>0.05)。结论 DEX能够减轻体外循环患者肠道屏障的损伤。

关键词: 体外循环, 右美托咪定, 肠道屏障功能, 内毒性血症, 炎症反应

Abstract: Objective To investigate the effects of dexmedetomidine(DEX)on the intestinal barrier injury in patients with cardiopulmonary bypass. Methods A total of 60 patients undergoing cardiopulmonary bypass cardiac surgery were randomly divided into DEX group(n=30)and control group(n=30). The DEX group was given DEX intervention and the control group was given saline infusion of the same volume. Venous blood samples were collected before administration(T0), immediately after cardiopulmonary bypass(T1), 2 hours after operation(T2), 6 hours after operation(T3)and 24 hours after operation(T4). The levels of intestinal fatty acid binding protein(I-FABP), endotoxin(LPS), interleukin-6(IL-6)and interleukin-10(IL-10)were measured. The first defecation time, intensive care unit stay time, hospital stay, mortality and adverse reactions of the two groups were recorded. Results All 60 patients completed the study protocol, and no death or serious complications were observed. The levels of serum I-FABP, LPS, IL-6 and IL-10 in either group at different time points were significantly different(P<0.001), and the levels at T1-T4 were higher than those at T0. The levels of serum I-FABP, LPS, IL-6 and IL-10 were significantly different between the two groups(P=0.029; P=0.002; P=0.022; P=0.022), and the levels of I-FABP, LPS, IL-6 in DEX group at T1-T4 were lower than those in control group, but the levels of IL-10 were higher than those in control group. There were no significant differences in the first defecation time, ICU stay time and hospital stay between the two groups(P>0.05). Conclusion DEX can alleviate the damage of intestinal barrier in patients with cardiopulmonary bypass.

Key words: Cardiopulmonary bypass, Dexmedetomidine, Gut barrier function, Endotoxemia, Inflammation

中图分类号:

R614

李锐,石存现,于翠翠. 右美托咪定对30例体外循环患者肠道屏障损伤的影响[J]. 山东大学学报 (医学版), 2022, 60(7): 83-88.

LI Rui, SHI Cunxian, YU Cuicui. Effects of dexmedetomidine on intestinal-related injury during cardiopulmonary bypass[J]. Journal of Shandong University (Health Sciences), 2022, 60(7): 83-88.

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