摘要
目的探讨右美托咪定(DEX)应用于脑梗死介入取栓术中对急性脑梗死(ACI)患者再通后引起的脑缺血-再灌注(I/R)损伤的保护作用及其可能的分子机制。方法选取我院2018年1月-2021年1月收治的急性脑梗死取栓后发生脑缺血-再灌注损伤的患者共120例,通过随机数表法将患者随机分为对照组与观察组。对照组患者给予常规吸氧、脱水、抗血小板等常规治疗,观察组患者在此基础上,自入院开始给予DEX泵入至术后72 h,两组患者治疗后分别观察患者的NIHSS评分、ADL评分、治疗总有效率,以及血清中超氧化物歧化酶(SOD)、丙二醛(MDA)、特异性烯醇化酶(NSE)、S-100B、TNF-α、IL-6含量变化。结果两组患者在接受取栓治疗后,NIHSS评分及ADL评分均有所改善,但与对照组相比较,观察组患者围术期应用DEX后,其NIHSS评分与ADL评分均显著改善,差异有统计学意义(P<0.05);经过治疗后,观察组有效率较对照组高,且两者间差异具有统计学意义(P<0.05);入院治疗前,两组患者血清中SOD、MDA、NSE、S-100B、TNF-α、IL-6含量水平差异无统计学意义(P>0.05);经过常规治疗及应用DEX后,对照组患者血清MDA、NSE、S-100B、TNF-α、IL-6含量高于观察组,SOD含量低于观察组,差异均具有统计学意义(P<0.05)。结论围术期应用DEX后,能够显著发挥对患者脑缺血-再灌注损伤的保护作用,其机制可能与DEX的抗氧化应激与抗炎作用有关。
Objective To investigate the protective effect of dexmedetomidine against cerebral ischemia-reperfusion(I/R)injury caused by recanalization and its probable molecular mechanism during interventional thrombectomy in patients with acute cerebral infarction(ACI).Methods Included in this study were a total of 120 ACI patients who had developed cerebral I/R injury after thrombectomy and were admitted to our hospital between January 2018 and January 2021.The patients were randomized into the control group and study group by random number table.The patients in the control group received routine treatment such as oxygen therapy,dehydration,and antiplatelets.In addition to these,the patients in the study group were given dexmedetomidine using an infusion pump starting from admission to 72 hours after the procedure.After the re-do thrombectomy,the two groups were compared for NIHSS and ADL scores,total treatment response,serum levels of superoxide dismutase(SOD),malondialdehyde(MDA),neuron specific enolase(NSE),S-100B,TNF-α,and IL-6.Results The NIHSS and ADL scores were improved after thrombectomy in either group.Compared with the control group,the study group receiving perioperative dexmedetomidine showed significantly greater improvement in NIHSS and ADL scores,with statistically difference(P<0.05).The study group showed higher response to treatment than did the control group,with statistically significant difference(P<0.05).Before the procedure,there were no significant differences in serum levels of SOD,MDA,NSE,S-100B,TNF-α,and IL-6 between the two groups(P>0.05).After routine treatment w/o dexmedetomidine,the control group had higher levels of MDA,NSE,S-100B,TNF-αand IL-6,and lower content of SOD in serum,compared with the study group.These differences were statistically significant(P<0.05).Conclusion Perioperative dexmedetomidine can significantly protect patients against cerebral I/R injury,probably via a mechanism related to the anti-oxidative stress and anti-inflammatory effects of dexmedetomidine.
作者
武娟
姜晓瑞
Juan Wu;Xiaorui Jiang(Department of Anesthesiology,Second Hospital of Shanxi Medical University,Taiyuan 030001,China)
出处
《中华生物医学工程杂志》
CAS
2021年第5期506-510,共5页
Chinese Journal of Biomedical Engineering
关键词
急性脑梗死
缺血-再灌注损伤
右美托咪定
分子机制
Acute cerebral infarction
Ischemia reperfusion injury
Dexmedetomidine
Molecular mechanism
