右美托咪定对老年高血压患者下肢缺血再灌注后心肌损伤的影响

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Abstract Objective To investigate the effect of Dexmedetomidine on myocardial injury after lower extremity ischemia reperfusion in elderly hypertension patients. Methods A total of 60 elderly hypertension patients who underwent knee replacement in the First Hospital of Hebei Medical University from January 2019 to December 2020 were selected, they were divided into Dexmedetomidine group (group D, 30 cases) and control group (group C, 30 cases) by random number table method. Group D was given Dexmedetomidine 1 μg/kg after anesthesia induction, and maintained at 0.4 μg/(kg·h) until 30 min before the end of surgery; group C was given normal saline in the same way. Venous blood was collected at before tourniquet (T0), 20 min (T1), 2 h (T2), and 12 h (T3) after tourniquet loosening in two groups. The levels of serum inflammatory factors (tumor necrosis factor-α [TNF-α], interleukin-6 [IL-6]), oxidative stress index (malondialdehyde [MDA], superoxide dismutase [SOD]), and myocardial injury markers (creatine kinase isoenzyme [CK-MB], troponin I [cTnI]) were determined. Results The levels of TNF-α, IL-6, and MDA in two groups at T1-T3 were higher than those at T0, and the levels of TNF-α, IL-6, and MDA in group D at T1-T3 were lower than those in group C, and the differences were statistically significant (P < 0.05). The levels of SOD at T1-T3 in two groups were lower than those at T0, and the levels of SOD at T1-T3 in group D were higher than those in group C, and the differences were statistically significant (P < 0.05). The levels of CK-MB and cTnI at T2, T3 in two groups were higher than those at T0, and the levels of CK-MB and cTnI in group D at T2, T3 were lower than those in group C, and the differences were statistically significant (P < 0.05). Conclusion Dexmedetomidine can significantly reduce tourniquet related inflammation and oxidative stress in elderly hypertension patients and reduce myocardial injury after lower extremity ischemia reperfusion.

Key words： Dexmedetomidine Elderly hypertension Tourniquet Ischemia reperfusion injury Inflammatory response Oxidative stress

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	LIU Xiuye WANG Li ZHOU Changhao MU Xiu’e GUO Qiongmei

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LIU Xiuye WANG Li ZHOU Changhao MU Xiu’e GUO Qiongmei. Effect of Dexmedetomidine on myocardial injury after lower extremity ischemia reperfusion in elderly hypertensive patients#br#[J]. 中国医药导报, 2022, 19(4): 107-110,123.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2022/V19/I4/107

[1] Estefania O，Hena P，Stella K，et al. Hypertension in older adults： Assessment, management, and challenges [J]. Clin Cardiol，2020，43（2）：99-107.
[2] 魏利霞，周稚川.硬膜外麻醉联合全身麻醉对老年高血压患者血流动力学和应激反应的影响[J].湖南师范大学学报：医学版，2018，15（3）：122-125.
[3] Xu Z，Wang D，Zhou Z，et al. Dexmedetomidine Attenuates Renal and Myocardial Ischemia/Reperfusion Injury in a Dose-Dependent Manner by Inhibiting Inflammatory Response [J]. Ann Clin Lab Sci，2019，49（1）：31-35.
[4] 张金辉，蔡淑女.右美托咪定全程泵注对体外循环下心脏瓣膜置换术患者的心肌保护作用[J].中华全科医学，2020，18（5）：752-756.
[5] 中国高血压防治指南修订委员会，高血压联盟（中国），中华医学会心血管病学分会中国医师协会高血压专业委员会，等.中国高血压防治指南（2018年修订版）[J].中国心血管杂志，2019，24（1）：24-56.
[6] Wu ZL，Jacques RJD，Zhu Y. Dexmedetomidine Protects against Myocardial Ischemia/Reperfusion Injury by Ameliorating Oxidative Stress and Cell Apoptosis through the Trx1-Dependent Akt Pathway [J]. Biomed Res Int，2020， 25：8979270.
[7] 宋雪萍，王彦松.右美托咪定在心脏缺血再灌注损伤中的研究进展[J].中国医药导报，2017，14（13）：42-45.
[8] 王全伟，凡文博，王智昊，等.氧化应激与心血管疾病关系的研究进展[J].中国老年学杂志，2014，34（1）：270-273.
[9] Partha M，Nabil E，Mohamed AA，et al. Interplay of Oxidative Stress, Inflammation, and Autophagy：Their Role in Tissue Injury of the Heart, Liver, and Kidney [J]. Oxid Med Cell Longev，2018，22：2090813.
[10] 陈前修，李天梅，刘行.右美托咪定在老年2型糖尿病患者止血带下肢手术中的应用[J].天津医药，2020，48（12）：1210-1213.
[11] Seung HK，Yong SC. Effects of dexmedetomidine on malondialdehyde and proinflammatory cytokines after tourniquet-induced ischemia-reperfusion injury in total knee arthroplasty [J]. Minerva Anestesiol，2020，86（2）：223-224.
[12] 周素素，许辉疏，树华，等.允许性高碳酸血症对老年患者止血带相关肢体缺血再灌注所致肺损伤的影响[J]. 中国医药导报，2020，17（4）：89-93.
[13] 高见，张华，刘国成，等.右美托咪定对重型颅脑损伤患者术后血清炎症因子和神经细胞因子水平及预后的影响[J].中国医药导报，2021，18（1）：111-114，139.
[14] Seung HK，Do HK，Seokyung S，et al. Effects of dexmedetomidine on inflammatory mediators after tourniquet-induced ischemia-reperfusion injury: a randomized, double-blinded, controlled study [J]. Minerva Anestesiol，2019，85（3）：279-287.
[15] Cheng WJ，Wang MJ，Liu P，et al. Protective Effects of Dexmedetomidine and Oxycodone in Patients Undergoing Limb Ischemia-Reperfusion [J]. Med Sci Monit，2019， 25：9073-9084.
[16] 刘凤敏，张艳敏.炎症与老年原发性高血压病的关联机制研究进展[J].中国全科医学，2018，21（29）：3644-3647.
[17] 韩巍，韩艳丛，邱拥华，等.高血压合并左心室肥厚患者血清miRNA-29a-3p水平与心肌纤维化的相关性[J].河北医科大学学报，2019，40（7）：773-776，793.
[18] 王洪萌，魏颖，林群，等.不同手术方式下老年高血压患者围术期心肌损伤和氧化应激的变化[J].中华高血压杂志，2016，24（10）：974-977.
[19] Zhang J，Jiang H，Liu DH，et al. Effects of dexmedetomidine on myocardial ischemia-reperfusion injury through PI3K-Akt-mTOR signaling pathway [J]. Eur Rev Med Pharmacol Sci，2019，23（15）：6736-6743.
[20] 陈如霜，康振明，谢文钦.右美托咪定对行胃癌根除术老年患者免疫功能及炎性因子水平的影响[J].中外医学研究，2021，19（23）：32-34.
[21] 饶青，丛海涛.右美托咪定对腹腔镜手术患者血清炎症因子及术后认知功能的影响[J].中国现代医生，2021， 59（8）：111-114.
[22] 关晓娟，罗红.小剂量右美托咪定对腹腔镜结肠癌根治术患者术后应激反应、谵妄的影响[J].中国当代医药，2021，28（16）：129-131.
[23] 郭琼梅，刘秀叶，王莉.右美托咪定对体外循环手术患儿外周血中性粒细胞凋亡和NF-κB活性的影响[J].河北医科大学学报，2020，41（10）：1181-1184，1189.
[24] 任国强，陈萍，于金贵.右美托咪定对大鼠离体心脏缺血再灌注损伤心肌组织炎症反应和氧化应激损伤的影响[J].中国老年学杂志，2018，38（11）：2709-2712.
[25] Zhou X，Liu J，Xu ZP，et al. Dexmedetomidine inhibits the lipopolysaccharide-stimulated inflammatory response in microglia through the pathway involving TLR4 and NF-κB [J]. Kaohsiung J Med Sci，2019，35（12）：750-756.
[26] 邢现良，朱妍梦，汤斌铨，等.右美托咪定经门静脉预处理对肝部分切除术患者术中炎症反应和氧化应激的影响[J].临床麻醉学杂志，2020，36（4）：317-321.
[27] 于健，李睿，王琦.右美托咪定预处理对下肢缺血再灌注性肺损伤及一氧化氮/内皮素-1失衡的影响[J].天津医药，2015，3（5）：537-541.
[28] Kundra TS，Nagaraja PS，Singh NG，et al. Effect of dexm-edetomidine on diseased coronary vessel diameter and myocardial protection in percutaneous coronary interventional patients [J]. Ann Card Anaesth，2016，19（3）：394-398.