Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, P.R. China.
Gynaecological Oncology, Beijing Haidian Maternal & Child Health Hospital, Beijing 100080, P.R. China.
Biosci Rep. 2019 May 3;39(5). doi: 10.1042/BSR20190352. Print 2019 May 31.
The present study aimed to elucidate the effects of dexmedetomidine on kidney injury of parturients with preeclampsia (PE) undergoing cesarean section. Total 134 cesarean delivery women with PE were randomly divided into intervention group (IG) and control group (CG). Both groups underwent combined spinal and epidural anesthesia (CSEA), the IG was treated with 0.4 μg/(kg·min) dexmedetomidine for 10 min before surgery. The CG was treated with equivalent saline. Heart rate (HR), blood pressure, oxygen saturation (SpO) of the two groups were measured at different time point after administration. Level of inflammatory factors were detected by enzyme-linked immunosorbent assay (ELISA). Visual analogue score (VAS), Ramsay sedation score (RSS), and kidney injury related indexes were evaluated at different time points. The plasma-drug concentration of patients was determined by High Performance Liquid Chromatography (HPLC) method. Compared with CG, HR, PE, and diastolic blood pressure (DBP) showed lower level while SpO showed higher level in IG. Furthermore, expression of tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), and IL-10 in IG was decreased after drug administration, the contents of β2-MG, KIM-1 and urine protein were also decreased in contrast to the CG (all <0.05). Besides, VAS score was decreased but Ramsay score was increased in the IG (both <0.05). The results of HPLC showed that the half life of dexmedetomidine was about 20 min and it is speculated that the drug can be quickly metabolized within 24 h. Dexmedetomidine exerted protective effects on kidney injury of parturients with PE undergoing cesarean section.
本研究旨在阐明右美托咪定对行剖宫产术的子痫前期（PE）产妇肾损伤的影响。将 134 例行剖宫产术的 PE 产妇随机分为干预组（IG）和对照组（CG）。两组均行腰硬联合麻醉（CSEA），IG 于术前 10 min 以 0.4μg/（kg·min）的速度输注右美托咪定，CG 给予等量生理盐水。于给药后不同时间点测量两组患者的心率（HR）、血压、血氧饱和度（SpO2）。采用酶联免疫吸附法（ELISA）检测两组患者炎症因子水平。于不同时间点评估两组患者的视觉模拟评分（VAS）、 Ramsay 镇静评分（RSS）及与肾损伤相关的指标。采用高效液相色谱法（HPLC）测定患者的血浆药物浓度。与 CG 组相比，IG 组 HR、PE、舒张压（DBP）较低，SpO2 较高。此外，IG 组给药后肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和白细胞介素-10（IL-10）的表达降低，β2-MG、KIM-1 和尿蛋白的含量也低于 CG 组（均<0.05）。IG 组 VAS 评分降低， Ramsay 评分升高（均<0.05）。HPLC 结果显示，右美托咪定的半衰期约为 20 min，推测药物可在 24 h 内快速代谢。右美托咪定对行剖宫产术的 PE 产妇肾损伤具有保护作用。
