摘要
目的评价右美托咪定对重度颅脑损伤患者术后中性粒细胞明胶酶脂质运载蛋白(NGAL)、肾损伤因子-1(KIM-1)的影响。方法选取我院ICU在2019年9月至2020年10月期间收治的64例重度颅脑损伤并行急诊手术的患者为研究对象,随机分为A组(右美托咪定治疗组,n=32)和B组(对照组,n=32)。A组先以0.8mg/kg静脉缓慢泵注右美托咪定15min,继之以0.5mg/(kg h)持续泵注至术后72h;B组给予等容量生理盐水。于入组即时(T0)、6h(T6)、12h(T12)、24h(T24)、48h(T48)、72h(T72)测定血NGAL、KIM-1、肌酐(Cr)和尿NGAL、KIM-1浓度。结果与T0比较2组患者血、尿KIM-1、NGAL的水平在T6-T72明显增高(P<0.05);与B组比较,A组T6-T24时的血KIM-1、NGAL、T48时的Cr、T6-T24时的尿KIM-1、NGAL水平均明显降低(P<0.05)。Pearson相关分析显示尿KIM-1、NGAL水平在T0、T6、T12、T24、T48呈正相关(P<0.05)。结论右美托咪定可以降低重度颅脑损伤患者术后NGAL和KIM-1水平,减轻重度颅脑损伤患者围手术期诱发的肾损伤。
Objective To investigate the effects of dexmedetomidine on neutrophil gelatinase-associated lipocalin(NGAL)and kidney injury molecule-1(KIM-1)after surgery in patients with severe head injury.Methods 64 pa⁃tients with severe brain injury and undergoing emergency surgery who were in ICU from September,2019 to October,2010 were randomly divided into two groups(n=30 each):dexmedetomidine group(group A)and control group(group b).The patients in group A were intravenously administrated 0.8μg/kg dexmedetomidine 15 min,and followed by the dose of 05 ug/(kg.h)till the end of operation 72h.The patients in group B received equal volume of normal saline at the same way.The level of serum and urine NGAL,KIM-1,Cr were deter⁃mined at 0h(T0),6h(T6),12h(T12),24h(T24),48h(T48),and 72h(T72)after the brain surgery.Results Com⁃pared with T0,the level of serum and urine NGAL,KIM-1 at T6-T72 increased significantly in patients of 2 groups(P<0.05).Compared with group B,the serum KIM-1,NGAL at T6-T24 decreased significantly in group A(P<0.05).Compared with group B,the level of serum creatinine at T48 decreased significantly in group A(P<0.05).Compared with group B,the urine KIM-1,NGAL at T6-T24 decreased significantly in group A(P<0.05).Pearson correlation analysis showed urine KIM-1 and NGAL at T0,T6,T12,T24,T48 was positive⁃ly correlated(r=1,P<0.05;r=1,P<0.05;r=1,P<0.05;r=1,P<0.05;r=0.732,P<0.05).Result Dexmedetomidine can reduce the level of NGAL and KIM-1 after surgery in patients with severe head injury and alleviate renal in⁃jury.
作者
薛露
孙文斌
梅海峰
朱志云
XUE Lu;SUN Wen-bin;MEI Hai-feng;ZHU Zhi-yun(Taizhou People's Hospital,Taizhou Jiangsu 225300,China)
出处
《泰州职业技术学院学报》
2021年第5期64-68,共5页
Journal of Taizhou Polytechnic College
关键词
右美托咪定
颅脑损伤
肾损伤
dexmedetomidine
craniocerebral trauma
kidney injury
