右美托咪定对腔隙性脑梗死患者术后谵妄的影响 摘要：目的 评价右美托咪定对腔隙性脑梗死患者术后谵妄的影响。方法 择期行髋关节置换术的腔隙性脑梗死患者 60 例，分为 2 组（n=30）:右美托咪定组（D 组），对照组（C 组）。D 组于麻醉诱导后持续静脉泵注右美托咪定 0.5μg·kg-1·h-1 至术毕，C 组泵注等容量生理盐水。于麻醉诱导前（T0）、术毕（T1）和术后 24 h（T2）抽取颈内静脉球部血样，采用 ELISA 法测定血清 S100β 蛋白和脑源性神经营养因子（BDNF） 的浓度，并评估术后 3 d 内谵妄的发生 情 况 。 结 果 与 C 组 比 较 ， D 组 T1 、 T2 时 S100β 降 低（P<0.05），BDNF 升高（P<0.05），与 T0 时比较，2 组 T1、T2 时血 清 S100β 蛋 白 浓 度 升 高 （ P<0.05 ） ， BDNF 浓 度 降 低（P<0.05）。D 组术后谵妄发生率降低，术后谵妄发生的时间推迟（P<0.05）以及术后谵妄持续时间缩短（P<0.05）。结论 右美托咪定可减轻腔隙性脑梗死患者脑损伤，预防和改善其术后谵妄的发生。关键词：右美托咪定；腔隙性脑梗死；谵妄Effect of dexmedetomidine on postoperative delirium in lacunar infarction patients Abstract ： Objective To evaluate the effect of dexmedetomidine on postoperative delirium (POD) in lacunar infarction patients. Methods Sixty patients with lacunar infarction, scheduled for elective artificial hip replacement, were randomly divided into 2 groups (n=30):group D,0.5μg·kg-1·h-1 dexmedetomidine injected from anesthesia induction to the end of surgery, group C, the equal volume of normal saline was given instead .Blood samples were collected from the jugular bulb before anesthesia induction (T0) and at the end of surgery(T1), 24 hours after the surgery(T2), S100β protein and brain-derived neurotrophic factor (BDNF) in serum were measured by enzyme-linked immunosorbent assay. Evaluate the occurrence of POD within 3 days after operation. Results Compared with group C,S100β were decreased (P<0.05) and BDNF were increased(P<0.05)at...
