不同浓度右美托咪啶对小儿麻醉后血清肌钙蛋白I、C反应蛋白以及补体水平的影响

目的:探讨不同浓度右美托咪啶对小儿麻醉后血清肌钙蛋白I、C反应蛋白(CRP)及补体水平的影响。方法:选取我院收治的拟行手术的患儿60例,根据应用右美托咪定的浓度随机分为A、B、C三组,每组各20例。A、B组患儿予右美托咪啶0.5、0.25μg/kg的负荷剂量静脉推注给药10分钟,然后以0.2-0.7μg/kg/h的速度持续静脉微量泵入维持患者镇静状态,C组直接以右美托咪啶0.2-0.7μg/kg/h的速度持续泵入维持镇静状态。比较三组患儿麻醉术后的苏醒情况,麻醉前后不同时点血清肌钙蛋白I、C反应蛋白及补体水平的变化。结果:治疗前,三组患儿的各项指标比较均无统计学差异(P0.05);治疗后,与A、C两组比较,B组患者自主呼吸恢复时间、气管导管拔管时间、解除监护时间显著缩短(P0.05),术后24、72 h血清CRP水平更低,术后1、6、24 h血清肌钙蛋白I水平较低(P0.05),术后1、24、72 h血清补体水平较高(P0.05)。结论:0.25μg/kg浓度的右美托咪啶对于对小儿麻醉后血清肌钙蛋白I、C反应蛋白及补体水平的影响明显,且有助于患儿术后的苏醒。

Effect of Different Concentrations of Dexmedetomidine on the SerumCRP,Troponin I and Complement Levels of Children after Anesthesia

Objective:To investigate the effects of different concentrations of dexmedetomidine on the serum CRP, troponin I andcomplement levels of children after anesthesia.Methods:60 patients undergoing operation in our hospital were selected and randomly dividedinto three groups according to the application of different concentrations of dexmedetomidine, 20 cases in each group. Children ingroup A and B were given 0.5, 0.25 ug/kg dexmedetomidine through intravenous injection for 10 min, and then were maintained bydexmedetomidine at 0.2-0.7 ug/kg/h through continuous intravenous trace pumping, while children in group C were given dexmedetomidineat 0.2-0.7 ug/kg/h through continuous intravenous trace pumping alone. The analepsia time, serum CRP, troponin I and complementlevels of children at different time points before and after anesthesia were compared between three groups.Results:Before treatment,no significant difference was found in the different indicators between three groups (P>0.05). After treatment, comprared withgroup A and group C, the spontaneous breathing recovery time, tracheal extubation time, lift the monitoring time of children in group Bwere all significantly shorter (P<0.05), the serum CRP levels at 24, 72 h after operation were significantly lower, the cardiac troponin Ilevels at 1, 6 24 h after operation were also significantly lower (P<0.05), while the serumcomplement levels at 1, 24,72 h after operationwere obviously higher(P<0.05).Conclusion:0.25 ug/kg dexmedetomidine had obvious effect on the serumcardiac troponin I, C reactiveprotein and complement levels of children after anesthesia, and could promote the analepsia of children.