国际麻醉学与复苏杂志   2017, Issue (7): 10-10
    
右美托咪定对食管癌根治术患者肠型脂肪酸结合蛋白浓度的影响
张瑛1()
1.上海市第六人民医院东院
Effect of dexmedetomidine on intestinal fatty acid binding protein in esophageal cancer patients receiving radical resection
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摘要:

目的 观察右美托咪定(dexmedetomidine, Dex)对食管癌根治术患者肠型脂肪酸结合蛋白(intestinal fatty acid binding protein, I-FABP)浓度的影响。 方法 择期行食管癌根治术患者40例,采用随机数字表法分为2组(每组20例):Dex组(D组),于麻醉诱导前10 min静脉输注Dex 0.5 μg/kg(10 min内输入),以0.5 μg·kg-1·h-1持续泵注;对照组(C组),予等量生理盐水;两组均于手术结束前30 min停药。分别于麻醉诱导前10 min(T1)、手术开始后10 min(T2)、手术开始后1 h(T3)、手术开始后2 h(T4)、手术结束前30 min(T5)、手术结束后2 h(T6)采集桡动脉血5 ml于促凝管,同时留取尿液标本5 ml,离心后备检。 结果 与C组比较[分别为(6.15±0.35)、(7.25±0.13)、(6.81±0.65)、(6.38±0.14) mg/L],D组T3~T6时点血清I-FABP浓度降低[分别为(5.66±012)、(6.80±0.18)、(6.42±0.70)、(5.31±0.21) mg/L],差异有统计学意义(P<0.05);与C组比较[分别为(6.82±0.10)、(7.89±0.53)、(6.38±0.14) mg/L],D组T3、T4、T6时点尿液I-FABP浓度降低[分别为(6.23±0.15)、(6.98±0.20)、(5.80±0.15) mg/L],差异有统计学意义(P<0.05)。 结论 Dex可降低食管癌根治术患者I-FABP浓度,对肠黏膜屏障功能具有一定的保护作用。

关键词: 右美托咪定; 食管癌根治术; 肠型脂肪酸结合蛋白
Abstract:

Objective To observe the effect of dexmedetomidine(Dex) on intestinal fatty acid binding protein(I-FABP) in esophageal cancer patients receiving radical resection. Methods Forty patients undergoing esophageal cancer radical resection were randomly divided into two groups. In group D (n=20), 0.5 μg/kg Dex was intravenously infused within 10 min before anaesthesia, and was then persistently infused at the rate of 0.5 μg·kg-1·h-1. In group C(n=20), saline, instead of Dex, was infused with the same regimen as Dex. Blood samples were collected at a series of time points: 10 min before anaesthesia(T1), 10 min (T2), 1 h (T3), 2 h (T4) after the initiation of operation, 30 min before the end of operation(T5), and 2 h after operation(T6). Results Compared with group C, serum concentrations of I-FABP in group D were significantly lower at T3-T6[(5.66±012), (6.80±0.18), (6.42±0.70), (5.31±0.21) mg/L vs (6.15±0.35), (7.25±0.13), (6.81±0.65), (6.38±0.14) mg/L](P<0.05), similarly, urine concentrations of I-FABP significantly decreased in group D at T3-T4 and T6 [(6.23±0.15), (6.98±0.20), (5.80±0.15) mg/L vs (6.82±0.10), (7.89±0.53), (6.38±0.14) mg/L](P<0.05). Conclusions Dex can reduce I-FABP in esophageal cancer patients receiving radical resection, suggesting that it may have protective effects on intestinal barrier.

Key words: Dexmedetomidine; Esophageal cancer radical resection; Intestinal fatty acid binding protein