Effects of Dexmedetomidine on Myocardial and Brain Injury in Children with Congenital Heart Disease during Perioperative Perio

Li Na; Li Tiejun; Xiong Lu; Wu Yehua; Chen Xiaojian; Meng Yazhen; Wu Duozhi; Xiong Yaqin; Fang Dengfeng

doi:10.13407/j.cnki.jpp.1672-108X.2020.10.004

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Effects of Dexmedetomidine on Myocardial and Brain Injury in Children with Congenital Heart Disease during Perioperative Perio

更新时间：2022-11-03

- Effects of Dexmedetomidine on Myocardial and Brain Injury in Children with Congenital Heart Disease during Perioperative Perio
- Vol. 26, Issue 10, Pages: 11-14(2020)
- 作者机构：
  
  1. 海南省人民医院，海南医学院附属海南医院,海南,海口,570100
  2. 四川大学华西第二医院,四川,成都,610041
  3. 四川大学华西第一医院,四川,成都,610041
- 作者简介：
- 基金信息：
- DOI：10.13407/j.cnki.jpp.1672-108X.2020.10.004
  CLC：
- Published：2020，
  
  Published Online：10 October 2020，
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Li Na, Li Tiejun, Xiong Lu, et al. Effects of Dexmedetomidine on Myocardial and Brain Injury in Children with Congenital Heart Disease during Perioperative Perio. [J]. 26(10):11-14(2020)
DOI：

Li Na, Li Tiejun, Xiong Lu, et al. Effects of Dexmedetomidine on Myocardial and Brain Injury in Children with Congenital Heart Disease during Perioperative Perio. [J]. 26(10):11-14(2020) DOI： 10.13407/j.cnki.jpp.1672-108X.2020.10.004.

摘要

目的：探讨右美托咪定对先天性心脏病患儿围手术期血流动力学、心肌及脑功能指标的影响。方法：选取海南省人民医院及四川大学华西第二医院2017年8月至2018年8月收治的房间隔缺损或室间隔缺损需行修补术患儿98例，随机分为观察组（49例）和对照组（49例）。对照组进行基础常规麻醉、气管插管和机械通气，观察组在对照组基础上静脉注射右美托咪定，剂量为0.5 μg/(kg·d)，直到手术完成。检测两组患儿体外循环（CPB）开始前（T1）、CPB结束10 min（T2）、术后6 h（T3）和术后12 h（T4）4个时间点血流动力学指标（心率、收缩压、舒张压），在这4个时间点分别采集血液，采用ELISA试剂盒检测S-100β和神经元特异性烯醇化酶（NSE）水平以及缺血修饰白蛋白（IMA）、心肌肌钙蛋白I（cTnI）水平。结果：与对照组比较，观察组T2、T3时间点心率降低（P<0.05），收缩压、舒张压升高（P<0.01）；观察组T2、T3、T4时间点IMA、cTnI、S-100β、NSE水平均降低（P<0.01）。与T1时间点比较，观察组T2和T3时间点心率均升高（P<0.05）；收缩压和舒张压各时间点比较差异无统计学意义（P>0.05）；T2、T3、T4时间点IMA、cTnI、S-100β、NSE水平显著升高（P<0.05）。结论：右美托咪定可维持先天性心脏病患儿动脉血压的稳定、降低心率、改善心肌损伤，降低NES和S-100β蛋白的水平。

Abstract

Objective: To probe into the effects of dexmedetomidine on hemodynamics

myocardial and brain function indexes in children with congenital heart disease during perioperative period. Methods: A total of 98 children with atrial septal defect or ventricular septal defect admitted into Hainan General Hospital and West China Second University Hospital

Sichuan University from Aug. 2016 to Aug. 2018 were extracted to be randomly divided into the observation group and the control group

with 49 cases in each group. The control group received conventional anesthesia

tracheal intubation and mechanical ventilation. The observation group was given intravenous injection of dexmedetomidine at a dose of 0.5 μg/(kg·h) on the basis of the control group until the surgery was completed. Hemodynamic indicators (heart rate

systolic blood pressure and diastolic blood pressure) were measured before cardiopulmonary bypass (CPB) surgery (T1)

10 minutes after CPB (T2)

6 hours after CPB (T3)

and 12 hours after CPB (T4). Blood was collected at the four time points. Levels of S-100β and neuron-specific enolase (NSE)

ischemia-modified albumin (IMA) and cardiac troponin I (cTnI) were detected by ELISA. Results: Compared with the control group

the heart rate of the observation group decreased at T2 and T3 (P<0.05)

while systolic and diastolic blood pressure increased (P<0.01). The levels of IMA

cTnI

S-100β and NSE in the observation group decreased at T2

and T4 (P<0.01). Compared with T1

the heart rate increased at T2 and T3 in the observation group (P<0.05). There was no significant difference between systolic blood pressure and diastolic blood pressure at each time point (P>0.05). The levels of IMA

cTnI

S-100β and NSE increased significantly at T2

T3 and T4 (P<0.05). Conclusion: Dexmedetomidine can maintain the stability of arterial blood pressure in children with congenital heart disease

reduce the heart rate

improve the myocardial damage

and decrease the levels of NSE and S-100β protein.

关键词

右美托咪定先天性心脏病血流动力学心肌损伤脑损伤

Keywords

exmedetomidinecongenital heart diseasehemodynamicsmyocardial injurybrain injury

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