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Effect of sedation by infusion of dexmedetomidine on inflammatory factors in patients with severe trauma
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF PATHOPHYSIOLOGY
- Issue:
- 11
- DOI:
- 10.3969/j.issn.1000-4718.2012.11.012
- Key Word:
- 右旋美托咪啶;咪唑安定;镇静;创伤;炎症介质
Abstract： 目的:探讨右旋美托咪啶(DEX)在严重创伤患者短期镇静治疗中对严重创伤后炎症因子的影响.方法:随机将60例入住重症监护病房(ICU)的严重创伤患者分为3组:DEX镇静组(DEX组,n=20)、咪达唑仑(MDZ)镇静组(MDZ组,n=20)和不用镇静剂的对照组(n=20).DEX组:先静脉注射DEX负荷量1～2 μg/kg (＞10 min),继以微量注射泵持续静脉泵注维持量0.2～0.7 μg·kg-1·h-1.MDZ组:先静脉注射MDZ负荷量0.03～0.3 mg/kg,继以微量注射泵持续静脉泵注维持量0.03～0.2 mg·kg-1·h-1.镇静2组均以Ramsay氏镇静评分分级Ⅱ～Ⅳ级为镇静目标,根据Ramsay评分调整用量,实施2 d的短程镇静治疗.分别检测患者在入院时、24 h和48 h血清中白细胞介素1(IL-1)、IL-6、肿瘤坏死因子α(TNF-α)和C反应蛋白(CRP)水平.结果:3组患者TNF-α、IL-1、IL-6和CRP水平在入住ICU时均明显高于正常值,3组差异无统计学意义(P>0.05);对照组TNF-α、IL-1、IL-6和CRP在24 h和48 h逐步升高,而DEX组和MDZ组的上述指标有所下降,分别与对照组比较差异有统计学意义(P<0.05);DEX组和MDZ组TNF-α、IL-1、IL-6和CRP水平在24 h无显著差异(P>0.05),但在48 h差异显著(P<0.05).结论:右旋美托咪啶可在一定程度上降低创伤后过度应激反应,阻止炎症介质的进一步产生和释放,有助于严重创伤患者的稳定和恢复.
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