摘要
目的:观察应用右美托咪定的肾癌根治术患者围术期血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、血肌酐(Scr)和血尿素氮(BUN)水平的变化,阐明右美托咪定对其免疫功能和肾功能的影响。方法:选择择期行肾癌根治术患者60例,随机分为右美托咪定组和对照组,每组30例,2组患者均于麻醉诱导前(T0)、手术1h(T1)、术毕(T2)、术后1d(T3)和术后3d(T4)晨抽取静脉血,测定血清TNF-α、IL-6、Scr和BUN水平。结果:与T0时比较,右美托咪定组患者在各时点血清TNF-α和IL-6水平差异无统计学意义(P>0.05),对照组患者T1～T3时血清TNF-α和IL-6水平明显升高(P<0.05);与对照组比较,右美托咪定组患者T1～T3时血清TNF-α和IL-6水平均明显降低(P<0.05)。2组患者围术期Scr和BUN水平比较差异无统计学意义(P>0.05)。结论:全麻期间持续静脉输注右美托咪定可有效降低肾癌根治术患者围术期血清IL-6和TNF-α水平,抑制围术期应激反应,且对肾功能无明显影响。
Objective To observe the effects of dexmedetomidine on levels of tumor necrosis factor-α（TNF-α）,interleukin-6（IL-6）,serum creatinine（Scr） and blood urea nitrogen（BUN） in the patients undergoing radical nephrectomy during perioperative period,and to probe the influences of dexmedetomidine on immune function and renal function.Methods Sixty patients with kidney cancer undergoing radical nephrectomy were randomly devided into dexmedetomidine group（n=30） and control group（n=30）.The blood samples were taken immediately before induction of anesthesia（T0）,1 h after the beginning of operation（T1）,at the end of operation（T2）,1 d after operation（T3） and 3 d after operation（T4） for determining the levels the of TNF-α,IL-6,Scr and BUN.Results Compared with T0 time point,the levels of serum TNF-α and IL-6 of the patients in dexmedetomidine group had no sianificant differences at all time points（P0.05）;the levels of serum TNF-α and IL-6 of the patients in control group were significantly increased at T1-T3 time points（P0.05）.Compared with control group,the levels of serum TNF-α and IL-6 of the patients in dexmedetomidine group were significantly decreased at T1-T3 time points（P0.05）.There were no significant differences of Scr or BUN levels between two groups during perioperative period（P0.05）.Conclusion Continuously intravenous infusion of dexmedetomidine may effectively decrease the levels of serum TNF-α and IL-6 in patients undergoing radical nephrectomy during perioperative period and inhibit the perioperative stress response,and doesn＇t have influence on renal function.
出处
《吉林大学学报（医学版）》
CAS
CSCD
北大核心
2013年第3期588-591,共4页
Journal of Jilin University：Medicine Edition
基金
浙江省宁波市医学科技计划项目资助课题(2009A24)
关键词
右美托咪定
肾肿瘤
白细胞介素6
肿瘤坏死因子α
血肌酐
血尿素氮
dexmedetomidine
kidney neoplasms
interleukin-6
tumor necrosis factor-α
serum creatinine
blood urea nitrogen
