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 and complement levels of children after anesthesia.Methods:60 patients undergoing operation in our hospital were selected and randomly divided into three groups according to the application of different concentrations of dexmedetomidine, 20 cases in each group. Children in group A and B were given 0.5, 0.25 ug/kg dexmedetomidine through intravenous injection for 10 min, and then were maintained by dexmedetomidine at 0.2-0.7 ug/kg/h through continuous intravenous trace pumping, while children in group C were given dexmedetomidine at 0.2-0.7 ug/kg/h through continuous intravenous trace pumping alone. The analepsia time, serum CRP, troponin I and complement levels 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 with group A and group C, the spontaneous breathing recovery time, tracheal extubation time, lift the monitoring time of children in group B were all significantly shorter (P<0.05), the serum CRP levels at 24, 72 h after operation were significantly lower, the cardiac troponin I levels at 1, 6 24 h after operation were also significantly lower (P<0.05), while the serumcomplement levels at 1, 24,72 h after operation were obviously higher(P<0.05).Conclusion:0.25 ug/kg dexmedetomidine had obvious effect on the serumcardiac troponin I, C reactive protein and complement levels of children after anesthesia, and could promote the analepsia of children.