右美托咪定对腹腔镜全子宫切除术患者氧化应激反应的影响

目的：观察并评价右美托咪定（dexmedetomidine，Dex）对腹腔镜全子宫切除术患者氧化应激反应的影响。方法择期全麻行腹腔镜全子宫切除术患者40例，随机分为两组：D组（Dex组，n＝20），Dex静脉泵注负荷剂量为1μg·kg－1（15 min内输注完），然后以0．5μg·kg－1·h－1持续泵注至手术结束前30 min。C组（对照组，n＝20），同样方式输注生理盐水。于麻醉前（T0）、气腹结束即刻（T1）、气腹结束后30 min（T2）和术后24 h（T3）4个时间点记录平均动脉压（MAP）、心率（HR）并抽取静脉血，测定血清过氧化氢（H2 O2）、丙二醛（MDA）和总抗氧化态（TAS）浓度。结果与T0相比，C组MAP在T1、T2时间点差异有显著性（P＜0．05）。与T0相比，T1、T2时间点C组、D组H2O2、MDA增高，TAS降低（P＜0．05）。T3时D组H2O2、MDA与T0比较差异无显著性（P＞0．05），而C组仍较高（P＜0．05）；与C组相比，D组T2、T3时间点H2O2、MDA浓度低，TAS浓度高（P＜0．05）。两组在T1时间点H2O2、MDA差异无显著性（P＞0．05），但D组较C组TAS浓度高（P＜0．05）。结论右美托咪定可减轻腹腔镜全子宫切除术患者氧化应激反应。

Effect of dexmedetomidine on oxidative stress of patients with laparoscopic hysterectomy

Objective To observe and evaluate the effect of dexmedetomidine (Dex)on oxidative stress of patients with laparoscopic hysterectomy.Methods Forty patients with laparoscopichysterectomy were assigned into 2 groups randomly:D group(Dex ,n=20), dexmedetomidine infusion intravenous loading dose of 1 μg·kg-1 (infusion completed within 15 minutes),then 0.5 μg·kg-1 · h-1 continuous infusion to 30 min before the end of surgery;C group (The control group,n=20),infusion of saline in the same way.Re-cords mean arterial pressure(MAP)and heart rate (HR)and venous blood sample was taken at four time points:before anesthesia (T0 ),immediate end of pneumoperitoneum (T1 ),30 min after pneumoperitoneum (T2 )and 24 h (T3 ).Concentrations of hydrogen peroxide(H2 O2 ),malondialdehyde (MDA)and total antioxidant status (TAS)in plasma were determined.Results Compared with T0,Group C MAP at T1、T2 time difference was significant (P<0.05).Compared with T0,H2O2,MDA increased and TAS reduced in the two groups at T1,T2 (P<0.05).There was no significant difference between T0and T3in group D in H2O2,MDA(P>0.05), while H2 O2 ,MDA were still higher in group C (P<0.05 ).Compared with group C,group D had low MDA concentration and high TAS concentration at T2 ,T3 time points (P<0.05 ).There were no significant differences in H2 O2 and MDA at T2 between the two groups (P>0.05 ).However,group D,compared with group C,had a higher TAS concentration (P<0.05 ).Conclusion Dexme-detomidine can reduce oxidative stress of patients undergoing laparoscopic hysterectomy.