摘要
为了了解右美托咪定对老年脊柱结核患者免疫功能和应激反应的影响，本研究选取了2016年4月至2017年11月我院收治的行病灶清除加植骨内固定融合术的老年脊柱结核患者74例，并根据麻醉用药不同将患者分为观察组和对照组。观察组在麻醉诱导前10min内静脉泵注右美托咪定0．5μg／kg，然后手术结束前40min内以0．3μg／（kg·h）的速度持续泵注，对照组采用静脉泵注等容生理盐水，两组麻醉诱导和术中麻醉维持所用药物及剂量相同。通过检测两组患者术后不同时间点免疫功能指标（CD3^＋，CD4^＋及CD4^＋／CD8^＋）、应激因子（Cor，AngⅡ，S-100β和IL-6）水平，观察患者认知功能和睡眠评分变化情况，本研究发现与对照组相比，注射右美托咪定可提高患者术后CD3^＋、CD4^＋及CD4^＋／CD8^＋水平（p〈0．05），降低应激因子Cor、AngII、S-100β和IL-6水平60〈0．05）。观察组患者术后认知功能与术前比较，无统计学差异（p〉0．05）。两组患者术后3个月时睡眠评分与术前比较，无统计学差异（p〉0．05）。本研究表明，右美托咪定应用于老年脊柱结核患者围手术期，可有效降低机体的应激反应，减轻对患者免疫功能的抑制，促进患者认知功能的恢复。这一研究为右美托咪定在老年脊柱结核患者的治疗中的应用提供了理论依据。
To understand the effect of dexmedetomidine on the immune function and stress response in elderly patients with spinal tuberculosis, we selected 74 elderly patients with spinal tuberculosis treated by internal fixation and bone graft fusion from April 2016 to November 2017 in our hospital as the objects, and they were divided into observation group and control group according to the different anesthetic drugs. The observation group was given 0.5 μg/kg dexmedetomidine through intravenous infusion 10 min before anesthesia induction, then infused continuously at speed of 0.3 μg/（k .h） for 40 min before the end of the operation, while the control group was given by intravenous infusion of equal volume of saline. The amount of drugs and dosages used for induction and maintenance of anesthesia in both groups were the same. Through detecting the levels of immunological indicators （CD3^＋, CD4^＋ and CD4^＋/CD8^＋） and stress factors （Cot, Ang Ⅱ, S-100β and IL-6） in patients of two groups at different time points after operation, and observing the variation of patients in cognitive function and sleep scores, we found that dextromotomime injection could improve the levels of CD3^＋, CD4^＋ and CD4^＋/ CD8^＋ after operation, and reduce those of stress factors Cor, Ang Ⅱ beta, S-100β and IL-6 （p〈0.05）, when compared with the control group. There was no significant difference in cognitive function of patients in the observation group （p 〉0.05）, and so were the sleep scores of both groups three months after operation （p 〉0.05）, when compared with those beforeoperation. Our research indicated that the application of exmedetomidine in elderly patients with spinal tuberculosis during the perioperative period could reduce the stress response and the inhibition of immune function of patients effectively, as well as promote the recovery of cognitive function in patients. This research might provide theoretical basis for the application ofexmedetomidine in the treatment of the elderly patients with spinal tuberculosis.
作者
樊娟
李爱军
孟宪勇
藤金亮
Fan Juan, Li Aijun ,Meng Xianyong, Teng Jinliang(The First Affiliated Hospital of Hebei North University, Zhangjiakou, 07506)
出处
《基因组学与应用生物学》
CAS
CSCD
北大核心
2018年第3期928-934,共7页
Genomics and Applied Biology
基金
河北北方学院附属第一医院资助
关键词
右美托咪定
脊柱结核
围手术期
免疫功能
Dexmedetomidine, Spinal tuberculosis, Perioperative period, Immune function
