浙江医学2016，Vol.38Issue(15)：1250-1252,1298,4.
右美托咪啶对老年患者全麻术后炎症因子水平及单核细胞TLR2和TLR4表达的影响
Effects of dexmedetomidine on inflammatory response and monocytes Toll-like receptor 2 and Toll-like receptor 4 expression in elderly patients receivmg abdominal operation in general anesthesia
摘要
Abstract
Objective To investigate the effects of dexmedetomidine on inflammatory response and monocytes Tol- like receptor 2 and Tol- like receptor 4 expression in elderly patients receiving abdominal surgery in general anesthesia. Methods Ninty one ASA physical status I orⅡpatients,aged 63- 80 yr ,scheduled for elective abdominal surgery under general anesthesia were randomly divided into two groups:control group (group C, n=45) and dexmedetomidine group (group D, n=46). Anesthesia was induced with midazolam, cisatracurium besilate, fentanil and etomidate. In group D, dexmedetomidine was infused over 10 min with loading dose 0.5μg/kg and then0.5μg/ (kg·h) as a maintenance dose until 30 min before the end of operation. Group C patients received the same volume of saline. Total anesthetics consumption were recorded. Before anesthesia induction(T0), at 1 h after the beginning of operation(T1), at 12 h after operation(T2) and at 24 h after operation(T3), venous blood samples were taken for determination of monocytes Tol- like receptor 2 and Toll- like receptor 4 expression by flow cytometrybased method and for serum concentrations of TNF- α、IL- 6 and high mobility group box- l protein (HMGBl) by ELISA. Results The consumption of anesthetics were lower in dexmedetomidine group than that in control group (P<0.05). Compared with group C, the expression of TLR2 and TLR4 in monocytes of venous blood was significantly down- regulated in dexmedetomidine group at the point of T1, T2 and T3 (P<0.05), and the serum TNF- α、IL- 6 and HMGBl levels were decreased in dexmedetomidine group at the point of T1, T2 and T3 (P<0.05). Conclusion Dexmedetomidine can suppress the inflammatory cytokines released and down regulate the expression of TLR2 and TLR4 in monocytes of venous blood.关键词
右美托咪啶/老年患者/炎症因子/Tol 样受体Key words
Dexmedetomidine/Elderly patients/Inflammatory factors/Tol- like receptor引用本文复制引用
王文伟,叶克平,王丽姝,叶琦刚,符新春,王华庆..右美托咪啶对老年患者全麻术后炎症因子水平及单核细胞TLR2和TLR4表达的影响[J].浙江医学,2016,38(15):1250-1252,1298,4.基金项目
浙江省卫计委一般科技项目 （）
