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右美托咪定对红细胞变形性及麻醉的影响。

Effects of dexmedetomidine on the deformability of erythrocytes and in anesthesia.

作者信息

Yang Xiao-Ming, Liu Jun, Ji Jun, Xie Jie

机构信息

Department of Anesthesiology, Air Force General Hospital, PLA, Beijing 100142, P.R. China ; Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical College, Xuzhou, Jiangsu 221002, P.R. China ; Jiangsu Province Key Laboratory of Anesthesiology and Analgesia Application Technology, Xuzhou, Jiangsu 221002, P.R. China.

Department of Information, Air Force General Hospital, PLA, Beijing 100142, P.R. China.

出版信息

Exp Ther Med. 2014 Jun;7(6):1631-1634. doi: 10.3892/etm.2014.1633. Epub 2014 Mar 27.

Abstract

The current study aimed to evaluate the impact of clinically relevant concentrations of dexmedetomidine on the deformability of erythrocytes and the effects of dexmedetomidine on the deformability of erythrocytes in patients undergoing laparoscopic cholecystectomy. Erythrocyte suspensions of different concentrations were divided into six groups: Control (group C); low, medium and high concentrations of dexmedetomidine (groups DL, DM and DH, respectively); yohimbine alone (group Y) and yohimbine mixed with dexmedetomidine (group YD). The suspensions were incubated in a thermostatic shaking incubator (50 rpm, 37°C) for 60 min. The nitric oxide (NO) concentrations and endothelial nitric oxide synthase (eNOS) activities of red blood cells and the erythrocyte deformability index (EI) were then measured. Patients (n=40) scheduled for laparoscopic cholecystectomy were randomly divided into a dexmedetomidine group (group A) and a control group (group B). The induction and maintenance of anesthesia in the two groups was identical. The EI and hematocrit (Hct) were assayed prior to anesthesia (T) and following the surgery (T). In the assay, the EI, the activity of eNOS and the NO concentration of the erythrocytes were significantly higher in groups DL, DM, DH and YD than in group C (P<0.05). In addition, the EI, the eNOS activity and NO concentration of the erythrocytes were higher in group DM than in group YD (P<0.05). In the patients, the EI value at T (0.90±0.04) was higher than at T (0.81±0.06) in group B (P<0.05). No statistically significant difference between the EI values at T and T was identified in group A (P>0.05). Dexmedetomidine treatment is able to improve the deformability of erythrocytes and in anesthesia. The improvement of erythrocyte deformability by dexmedetomidine may be partially associated with adrenergic receptors through activation of eNOS to enhance the concentration of NO in red blood cells.

摘要

本研究旨在评估临床相关浓度的右美托咪定对红细胞变形性的影响,以及右美托咪定对腹腔镜胆囊切除术患者红细胞变形性的作用。将不同浓度的红细胞悬液分为六组:对照组(C组);低、中、高浓度右美托咪定组(分别为DL组、DM组和DH组);单独使用育亨宾组(Y组)和育亨宾与右美托咪定混合组(YD组)。将悬液在恒温振荡培养箱(50 rpm,37°C)中孵育60分钟。然后测量红细胞的一氧化氮(NO)浓度和内皮型一氧化氮合酶(eNOS)活性以及红细胞变形性指数(EI)。计划进行腹腔镜胆囊切除术的患者(n = 40)被随机分为右美托咪定组(A组)和对照组(B组)。两组的麻醉诱导和维持相同。在麻醉前(T0)和手术后(T1)测定EI和血细胞比容(Hct)。在实验中,DL组、DM组、DH组和YD组红细胞的EI、eNOS活性和NO浓度均显著高于C组(P < 0.05)。此外,DM组红细胞的EI、eNOS活性和NO浓度高于YD组(P < 0.05)。在患者中,B组T1时的EI值(0.90±0.04)高于T0时(0.81±0.06)(P < 0.05)。A组T0和T1时的EI值之间未发现统计学显著差异(P > 0.05)。右美托咪定治疗能够改善红细胞在麻醉中的变形性。右美托咪定对红细胞变形性的改善可能部分与肾上腺素能受体有关,通过激活eNOS来提高红细胞中NO的浓度。

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