右美托咪定对重度颅脑损伤患者血清内脂素和高敏C-反应蛋白的影响

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Abstract Objective: To explore the effect of dexmedetomidine on serumvisfatin and high-sensitive C-reactive protein in patients with severe craniocerebral trauma. Methods: Seventy-two cases of severe craniocerebral trauma patients received emergency operation from August 2011 to August 2013 in our hospital were selected as research subjects, the patients were randomly divided into treatment group (n=36) and control group (n=36), patients in treatment group received intravenous injection of dexmedetomidine 0.5 μg/(kg•h) from the time before anesthesia induction to postoperative 3 days, patients in control group were given equal volume of saline. Venous blood samples were collected to determine serumvisfatin, Hs-CRP level before anesthesia induction (T0), at the end of the surgery (T1), on postoperative 1 day (T2), 3 days (T3), 5 days (T4) and 7 days (T5) respectively. Glasgow outcome scale (GOS) score was recorded after surgery for six months. Results: ①Compared with T0, serumvisfatin and Hs-CRP of two groups were significantly higher at T2-T4 (P<0.05), both indexes of treatment group at T5 were similar with those at T0, while both indexes of control group at T5 were significantly higher than those at T0 (P<0.05). Compared with control group, serumvisfatin and Hs-CRP of treatment group were significantly lower at T2-T5 (P<0.05). ②Spearman correlation analysis showed that the serum visfatin level was positively correlated with Hs-CRP (r=0.462, P=0.000), and also positively correlated with WBC count (r=0.221, P=0.028). ③Multi-factor logistic regression analysis showed that serum visfatin (OR=1.733, P<0.05) and Hs-CRP (OR=3.184, P<0.05) were positively correlated with poor prognosis (GOS score after six months<3 points). ④Rate of good prognosis in treatment group (88.9%) was significantly higher than that in the control group (66.7%) in term of GOS score after six months (x2=5.143, P=0.233). Conclusion: Serum visfatin is closely related to inflammatory response after brain injury and it companied with Hs-CRP are high risk factors for poor prognosis in patients with severe craniocerebral injury. Dexmedetomidine can obviously reduce serum visfatin and Hs-CRP levels and thus inhibit inflammation response so as to improve the prognosis of patients.

Key words： dexmedetomidine craniocerebral trauma visfatin high-sensitive C-reactive protein inflamm-atory response

Received: 09 June 2014

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	PENG Wenyong
	TU Wenlong
	LE Xinhui
	HU Chonghui
	DU Guangsheng.

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2015/V45/I2/126

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