右美托咪啶对急性主动脉夹层患者谵妄及血清CRP、MMPs、NT-proBNP、NE水平的影响

目的:探讨右美托咪啶对急性主动脉夹层患者谵妄及血清C反应蛋白(CRP)、基质金属蛋白酶(MMPs)、N端前脑钠肽(NT-proBNP)、中性粒细胞弹性蛋白酶(NE)水平的影响。方法:选择2014年1月~2017年1月我院收治的急性主动脉夹层患者84例,根据随机数字表法将其分为对照组(n=42)与研究组(n=42)。对照组入院后给予吗啡镇痛,研究组则给予右美托咪啶镇痛。观察对比两组治疗前与治疗24 h后C反应蛋白(CRP)、基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶-2(MMP-2)、NT-proBNP和NE水平、谵妄的发生率以及脱机持续时间与ICU入住时间。结果:治疗前两组患者CRP、MMP-9、MMP-2、NT-proBNP、NE水平比较无统计学差异(P0.05),治疗24h后研究组CRP、MMP-9、MMP-2、NT-proBNP、NE水平低于对照组与治疗前,差异有统计学意义(P0.05)。研究组术后谵妄的发生率为7.14%(3/42),低于对照组的26.19%(11/42),差异有统计学意义(P0.05)。研究组脱机持续时间与ICU入住时间均低于对照组,差异有统计学意义(P0.05)。结论:右美托咪啶不仅具有镇痛、镇静等效应,还对急性主动脉夹层患者炎性反应具有显著的抑制作用,且降低了谵妄的发生率,保证了患者的预后质量。

Effects of Dexmedetomidine on Delirium and Serum Levels of CRP, MMPs, NT-proBNP and NE in Patients with Acute Aortic Dissection

ABSTRACT Objective: To investigate the effects of dexmedetomidine on delirium and serum levels of C reactive protein (CRP), Matrix metalloproteinases (MMPs), N end forebrain natriuretic peptide (NT-proBNP) and neutrophil elastase (NE) in patients with acute aortic dissection. Methods: 84 patients with acute aortic dissection who were treated in our hospital from January 2014 to January 2017 were selected, they were divided into the control group (n=42) and the study group (n=42). The control group was given morphine anal- gesia immediately after admission, while the study group was given dexmedetomidine analgesia. The levels of CRP, MMP-9, MMP-2,NT-proBNP and NE,the incidence of delirium, and the duration of weaning and ICU stay time between the two groups were observed and compared before and after treatment of 24 h. Results: There was no significant difference in CRP, MMP-9, MMP-2, NT-proBNP and NE levels between the two groups before treatment (P>0.05). The levels of CRP, MMP-9, MMP-2, NT-proBNP and NE in the study group were lower than those in the control group after treatment of 24 h, and the difference was statistically significant (P<0.05). The incidence of postoperative delirium in the study group was 7.14%(3/42), which was lower than 26.19% (11/42) of the control group (P<0.05). The duration of weaning and ICU stay in the study group were lower than those in the control group, the difference was statistically significant (P<0.05). Conclusion: Dexmedetomidine not only has analgesic and sedative effects, it also has a significant inhibitory effect on inflammatory response in patients with acute aortic dissection, and reduce the incidence of delirium, the prognosis quality of the pa- tients is guaranteed.