中华老年多器官疾病杂志2020年2月28日第19卷第2期Chin J Mud Organ Ds Elderly,Vol.19,No.2,Feb.28,2020-115--临床研究•
右美托咪定对脓毒症相关性脑病患者炎症因子及S100卩蛋白的影响我懂得了珍惜作文
张林娜，耿晓娟*
(徐州医科大学附属医院重症医学科，徐外I221000)
庄稼院里的年轻人!摘要】目的分析右美托咪定和异丙酚对脓毒症相关性脑病(SAE)患者炎性因子及S100$蛋白的影响。方法入选徐州医科大学附属医院重症监护病房(ILU)2017年7月至2018年12月行机械通气的SAE患者50例，随机数表法分为异丙酚组和右美托咪定组，每组25例。分别接受异丙酚和右美托咪定治疗，比较2组患者用药后1h(Tl)、12h(T2)、24h(T3)、3d (T4)白细胞介素-6(IL-6)、肿瘤坏死因子-%TNF-)和中枢神经特异性蛋白S100$水平，以及不良反应、死亡率和留住ICU 时间。应用SPSS20.0统计软件对数据进行分析。依据数据类型，采用t检验或#检验进行组间比较％结果右美托咪定组相比异丙酚组患者T2、T3、T4时间点TNF-a[(17.83±2.09)和(19.96±2.65) ng/L；(14.95±3.37)和(18.83±4.46)ng/L；(&62±3,07)和(17.75±5,06)ng/L]、S100$蛋白[(0.69±0.05)和(0.61±0.04)"g/L；(0.62±0.03)和(0.55±0.03)"g/L；
(0.56±0.02)和(0.42±0,01)"g/L]水平低，T3、T4时间点IL-6[(340.71±10,37)和(390.89±12,26)ng/L；(240.
62±10.54)和(331.15±12,64)ng/L]水平低，差异均有统计学意义(6<0.05)。右美托咪定组患者1例呼吸抑制，4例心动过缓，2例低血压；异丙酚组患者2例呼吸抑制，3例心动过缓，4例低血压％右美托咪定组相比异丙酚组患者不良反应发生率+28%(7/25)和36%(9/25)]差异无统计学意义(6>0.05) %右美托咪定组患者4例死亡，入住ICU时间(13.19±2.26)d，异丙酚组患者2例死亡，入住ICU时间(13.07±2,16)d，2组预后比较差异均无统计学意义(6>0.05)%结论右美托咪定用于SAE患者可一定程度减轻炎症反应，获得理想的镇静效果％
!关键词】脓毒症相关性脑病；炎性反应；右美托咪定；异丙酚；S100$蛋白
!中图分类号】R614!文献标志码】A!DOI】10.11915/j..i s n.1671-5403.2020.02.028共享看世界
Effects of dexmedetomidine on infammatory respon and S100beta protein in patients with psis associatee encephalopathy
ZHANGLin-Na，GENG Xiao-Juan*
4xBxB(DepaetmentooCeiticayCaeeMedicine，A o iyiated HospitayooXuehou MedicayUnieeesity，Xuehou221000，China)
(Abstract]Objective To determine the effects of dexmedetomidine and propofol on inflammatoy respo
n and S100$protein in patients with psis associated encephalopathy(SAE).Methods A total of50SAE patients undergoing mechanical ventWation admitted to the intensive care unit(ICU)of our hospital from July2017to December2018were prospectively enrolled in this study.They weeeeandomyydieided intopeopoooygeoup and dexmedetomidinegeoup，25casin each geoup.Theyeeeysoointeeyeukin-6(IL-6)，tumor necrosis factor-ylpha(TNF-%and central nervous system specific protein S100$at1(T1)，12(T2)and24h(T3)，and3d (T4)aoteetheteeatment，incidenceooadeeeeeactions，moetayityand yength ooICUstayweeecompaeed between the2geoups.SPSS statictis20.0was ud to analyze the data.S tudent's t test or Chi-square test was employed for intergroup comparison.Results The levels oS TNF-at T2,T3and T4[(17.83±2.09)vs(19.96±2.65)ng/L，(14.95±3.37)vs(18.83±4.46)ng/L，(8.62±3.07)vs (17.75±5.06)ng/L],tho oS S100$[(0.69±0.05)vs(0.61±0.04)"g/L,(0.62±0.03)vs(0.55±0.03)"g/L,(0.56±0.02)vs (0.42±0.01)"g/L]at the eme tbie points,and tho oS IL-6[(340.71±10.37)vs(390.89±12.26)ng/L,(240.62±10.54)vs (331.15±12.64)ng/L]at T3and T4were sianbicantly lower in the dexmedetomidine group than the pypofol group(6<0.05). Theeeweee1caooeespieatoeydepee s ion，4casoobeadycaediaand2casoohypotension in thedexmedetomidinegeoup，and2 casooeespieatoeydepeession，3casoobeadycaedia，and4casoohypotension in thepeopoooPgeoup.NostatisticaPdi o eeencewas en in the incidence 六神装
赣州有什么好玩的of adver reactions between the2groups[28%(7/25)vs36%(9/25),6>0.05].In the dexmedetomidine geoup，4patientsdied，and theyength ooICUstaywas(13.19±2.26)d.Foethepeopoooygeoup，2patientsdied，and ICUyength was领导力培养
收稿日期：2019-06-14；接受日期：2019-10-08
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