摘要
目的探讨右美托咪定对全弓置换术患者脑氧代谢及外周血Th17/Treg细胞亚群的影响。方法92例全弓置换术患者随机分为对照组(46例)和观察组(46例),对照组给与常规麻醉诱导,观察组在常规麻醉诱导的基础上给予右美托咪定。观察两组麻醉诱导前(t_(0))、手术结束即刻(t_(1))、手术后12 h(t_(2))脑氧代谢、中枢神经特异性蛋白(S100β蛋白)和神经元特异性烯醇化酶(NSE)水平、外周血Th17和Treg细胞亚群及相关炎性细胞因子水平。结果观察组t_(1)和t_(2)时点SjvO2水平显著高于对照组(P<0.05),而AVDO2和CERO2水平显著低于对照组(P<0.05);观察组t_(2)时点S100β和NSE水平显著低于对照组(P<0.05);观察组t_(2)时点外周血Th17细胞和Th17/Treg比值水平显著低于对照组(P<0.05),而t_(2)时点外周血Treg细胞水平显著高于对照组(P<0.05);观察组t_(2)时点外周血IL-17水平显著低于对照组(P<0.05),而外周血TGF-β水平显著高于对照组(P<0.05)。结论右美托咪定能改善全弓置换术患者脑氧代谢及外周血Th17和Treg细胞亚群的失衡程度,从而起到脑保护的作用。
Objective To investigate the effect of dexmedetomidine on cerebral oxygen metabolism and peripheral blood Th17/Treg cell subsets in patients undergoing total arch replacement.Methods 92 patients with total arch replacement were randomly divided into control group(46 cases)and observation group(46 cases).The control group was given conventional anesthesia induction,and the observation group was given dexmedetomidine on the basis of conventional anesthesia induction.The levels of cerebral oxygen metabolism,central nerve specific protein(S100βprotein)and neuron-specific enolase(NSE),and Th17 and Treg cell subsets and related inflammatory cytokine levels in peripheral blood in the two groups were observed before anesthesia induction(t_(0)),immediately after surgery(t_(1)),and 12 h after surgery(t_(2)).Results SjvO2 level at t_(1)and t_(2)in the observation group was significantly higher than control group(P<0.05),While AVDO2 and CERO2 levels were significantlylower than those in control group(P<0.05).Compared with the control group,the S100βand NSE levels at t_(2)were significantly reduced(P<0.05).Compared with the control group,the peripheral blood Th17 cells and Th17/Treg ratio levels at t_(2)in the observation group were significantly reduced(P<0.05),while the Treg cell levels were significantly increased(P<0.05).Compared with the control group,the peripheral blood IL-17 level at t_(2)in the observation group was significantly decreased,while the TGF-βlevel was significantly increased(P<0.05).Conclusion Dexmedetomidine can improve cerebral oxygen metabolism and the imbalance of peripheral blood Th17 and Treg cell subsets in patients undergoing total arch replacement,thereby playing a protective role in the brain.
作者
吴新华
赵晓亮
徐桂萍
WU Xinhua;ZHAO Xiaoliang;XU Guiping(Department of Anesthesiology,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,830001,China)
出处
《新疆医学》
2023年第6期660-663,共4页
Xinjiang Medical Journal
基金
新疆维吾尔自治区人民医院院级课题(项目编号:20180201)
作者简介
吴新华,女,硕士,副主任医师,研究方向:器官功能保护;通信作者:徐桂萍,女,硕士,主任医师,研究方向:器官缺血缺氧的研究。E-mail:xgpsyl@126.com。
