中国医科大学学报2016，Vol.45Issue(12)：1077-1081,1085,6.DOI:10.12007/j.issn.0258-4646.2016.12.005
盐酸右美托咪定对开腹结直肠癌根治术患者围术期肺动态顺应性和外周血中TLR-2和TLR-4表达的影响
Effects of Dexmedetomidine on the Lung Compliance and the Expression of TLR-2 and TLR-4 in the Peripheral Blood during Perioperative Period in Patients Undergoing Open Colorectal Cancer Radical Surgery
摘要
Abstract
Objective To evaluate the effects of dexmedetomidine on perioperative pulmonary compliance and the expression of Toll⁃like recep⁃tor(TLR)⁃2 and TLR⁃4 in the peripheral blood during perioperative period in patients undergoing open colorectal cancer radical surgery. Meth⁃ods Twenty patients with colorectal cancer underwent elective general anesthesia,with ASA gradeⅠ⁃Ⅱand body mass index(BMI)<30 kg/m2, aged 30 to 68 years old,were enrolled for the study. They were randomly divided into control group(group C,n=10)and dexmedetomidine group (group D,n=10). In group D,dexmedetomidine was infused at a rate of 0.4μg·kg-1·h-1 from the beginning of surgery till 30 min before the end of surgery. The patients in group C received same manipulation as in group D except dexmedetomidine was replaced by normal saline. The mean ar⁃terial pressure(MAP)and heart rate(HR)were recorded before anesthesia induction(T0),30 min(T2),60 min(T3),and 90 min(T4)after the beginning of surgery,extubation(T6),and 3 min after extubation(T7). Airway pressure and lung dynamic compliance were recorded at T1⁃T7 time points,respectively. Vein blood samples were drawn to analyze the TLR⁃2,TLR⁃4 and tumor necrosis factorα(TNF⁃α)concentration at T0,T4,T7 and the day after operation(T8),respectively. Results Compared with group C,MAP and HR increased in group D at T6(P<0.05);lung dynamic compliance increased in group D at T4(P<0.05);TLR⁃2 and TLR⁃4 concentration in serum decreased in group D at T4, T7 and T8(P<0.05);TNF⁃αconcentration in serum decreased in group D at T4,T7 and T8(P<0.05). Conclusion Continuous infusion of 0.4μg·kg-1·h-1 dexmedetomidine can help to stabilize hemodynamics,relieve inflammatory stress response,maintain the relative stability of intra⁃operative hemodynamic parameters,and also can improve the pulmonary dynamic compliance of patients.关键词
右美托咪定/肺动态顺应性/Toll样受体2/Toll样受体4/肿瘤坏死因子αKey words
dexmedetomidine/lung dynamic compliance/Toll-like receptor 2/Toll-like receptor 4/tumor necrosis factorα分类
医药卫生引用本文复制引用
杨悦,马铃,代玉婷,马扬,孙雪晨,姜美玲..盐酸右美托咪定对开腹结直肠癌根治术患者围术期肺动态顺应性和外周血中TLR-2和TLR-4表达的影响[J].中国医科大学学报,2016,45(12):1077-1081,1085,6.基金项目
国家自然科学基金 （）
