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

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Abstract Objective To investigate the effect of Dexmedetomidine (DEX) on serum inflammatory factors and neurocytokines levels and prognosis in patients with severe craniocerebral injury after surgery. Methods From January 2017 to December 2019, 50 patients with severe craniocerebral injury admitted to intensive care unit (ICU) of Pidu District People’s Hospital of Chengdu City were selected and divided into group D and group C according to random number table method, 25 cases in each group. Group D received DEX 0.5-0.8 μg/(kg·h), group C received Midazolam 0.05-0.1 mg/(kg·h) for seven days. NIHSS scores were used to evaluate the degree of neurological deficit and intracranial pressure (ICP) at the time of admission to ICU (T0) and seven days after treatment (T1) in two groups. The incidence of complications of two groups was recorded at T1. Peripheral venous blood samples were collected at T0 and T1 to determine the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), central nerve specific protein (S100β), neuron specific enolase (NSE). The length of ICU stay and the total length of stay of two groups were recorded, and the prognosis was evaluated of two groups after three months. Results NIHSS score and ICP at T1 were lower than those at T0 in two groups (P < 0.01). NIHSS score and ICP at T1 in group D were lower than those in group C (P < 0.05 or P < 0.01). Total complication rate at T1 in group D was lower than that in group C (P < 0.01). The levels of IL-6 and TNF-α at T1 were significantly lower than those at T0 in two groups (P < 0.01). The levels of IL-6 and TNF-α at T1 in group D were lower than those in group C (P < 0.05 or P < 0.01). The levels of S100β and NSE at T1 were higher than those at T0 in two groups (P < 0.01). At T1, S100β and NSE levels in group D were lower than those in group C (P < 0.01). The length of ICU stay and total length of stay in group D were shorter than those in group C (P < 0.05 or P < 0.01). The prognosis of group D was better than that of group C after three months (P < 0.05). Conclusion DEX can reduce the degree of neurological deficit, reduce the incidence of ICP and complications, shorten the length of ICU stay and total hospital stay and improve the prognosis of patients.

Key words： Dexmedetomidine Interleukin-6 Tumor necrosis factor-α S100 proteins Neuron specific enolase Craniocerebral trauma

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	GAO Jian1 ZHANG Hua1 LIU Guocheng1 WANG Decong1 ZHAO Zeyu2▲

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GAO Jian1 ZHANG Hua1 LIU Guocheng1 WANG Decong1 ZHAO Zeyu2▲. Effect of Dexmedetomidine on serum inflammatory factors and neurocytokines levels and prognosis in patients with severe craniocerebral injury after surgery[J]. 中国医药导报, 2021, 18(1): 111-114,139.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2021/V18/I1/111

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