右美托咪定对食管癌根治术患者肠型脂肪酸结合蛋白浓度的影响

目的 观察右美托咪定(dexmedetomidine,Dex)对食管癌根治术患者肠型脂肪酸结合蛋白(intestinal fatty acidbinding protein,Ⅰ-FABP)浓度的影响.方法 择期行食管癌根治术患者40例,采用随机数字表法分为2组(每组20例):Dex组(D组),于麻醉诱导前10 min静脉输注Dex 0.5 μ.g/kg(10 min内输入),以0.5 μg·kg-1·h-1持续泵注;对照组(C组),予等量生理盐水;两组均于手术结束前30 min停药.分别于麻醉诱导前10 min(T1)、手术开始后10 min(T2)、手术开始后1 h(T3)、手术开始后2 h(T4)、手术结束前30 min(T5)、手术结束后2 h(T6)采集桡动脉血5ml于促凝管,同时留取尿液标本5 ml,离心后备检.结果 与C组比较分别为(6.15±0.35)、(7.25±0.13)、(6.81±0.65)、(6.38±0.14) mg/L],D组T3～T6时点血清Ⅰ-FABP浓度降低分别为(5.66±012)、(6.80±0.18)、(6.42±0.70)、(5.31±0.21) mg/L],差异有统计学意义(P＜0.05);与C组比较分别为(6.82±0.10)、(7.89±0.53)、(6.38±0.14) mg/L],D组T3、T4、T6时点尿液Ⅰ-FABP浓度降低分别为(6.23±0.15)、(6.98±0.20)、(5.80±0.15) mg/L],差异有统计学意义(P＜0.05).结论 Dex可降低食管癌根治术患者Ⅰ-FABP浓度,对肠黏膜屏障功能具有一定的保护作用.

Effect of dexmedetomidine on intestinal fatty acid binding protein in esophageal cancer patients receiving radical resection

Objective To observe the effect of dexmedetomidine (Dex) on intestinal fatty acid binding protein (Ⅰ-FABP) in esophageal cancer patients receiving radical resection.Methods Forty patients undergoing esophageal cancer radical resection were randomly divided into two groups.In group D (n=20),0.5 μg/kg Dex was intravenously infused within 10 min before anaesthesia,and was then persistently infused at the rate of 0.5 μg·kg-1 ·h-1.In group C (n=20),saline,instead of Dex,was infused with the same regimen as Dex.Blood samples were collected at a series of time points:10 min before anaesthesia(T1),10 min (T2),1 h (T3),2 h (T4)after the initiation of operation,30 min before the end of operation (T5),and 2 h after operation (T6).Results Compared with group C,serum concentrations of Ⅰ-FABP in group D were significantly lower at T3-T6(5.66±012),(6.80±0.18),(6.42±0.70),(5.31±0.21) mg/Lvs (6.15±0.35),(7.25±0.13),(6.81±0.65),(6.38±±0.14) mg/L](P＜0.05),similarly,urine concentrations of Ⅰ-FABP significantly decreased in group D at T3-T4 and T6 (6.23±0.15),(6.98±0.20),(5.80±0.15) mg/L vs (6.82±0.10),(7.89±0.53),(6.38±0.14) mg/L](P＜0.05).Conclusions Dex can reduce Ⅰ-FABP in esophageal cancer patients receiving radical resection,suggesting that it may have protective effects on intestinal barrier.