目的:研究右美托咪定联合乌司他丁对急性主动脉夹层术后RAAS系统、凝血指标、氧自由基的影响。方法:选择在本院接受覆膜支架腔内隔绝术治疗的48例主动脉夹层患者并随机分为两组,A组接受右美托咪定、乌司他丁联合常规麻醉,B组接受常规麻醉。手术前1天、手术中、手术结束后24小时,测定RAAS激素、凝血指标、氧自由基指标。结果:手术中及手术后,两组血清中REN、AT-II、ALD、FIB、DD、MDA、MPO的含量以及APTT、TT的水平均显著高于手术前,TAOC、TSOD的含量均显著低于手术前,且A组血清中REN、AT-II、ALD、FIB、DD、MDA、MPO的含量以及APTT、TT的水平均显著低于B组,TAOC、TSOD的含量均显著高于B组。结论:右美托咪定联合乌司他丁用于急性主动脉夹层手术能够抑制RAAS系统及氧自由基生成、改善凝血功能。

Objective: To study the effect of dexmedetomidine combined with ulinastatin on RAAS system, coagulation indexes and oxygen free radicals after acute aortic dissection surgery. Methods: A total of 48 patients with aortic dissection who accepted endovascular graft exclusion treatment in the hospital between May 2014 and February 2017 were selected and randomly divided into two groups, group A received dexmedetomidine, ulinastatin combined with general anesthesia, and group B received general anesthesia. The RAAS hormones, coagulation indexes and oxygen free radical indexes were measured 1 day before surgery, during operation and 24 hours after surgery. Results:During operation and after operation, serum REN, AT-II, ALD, FIB, DD, MDA and MPO contents as well as APTT and TT levels of both groups of patients were significantly higher than those before operation while TAOC and TSOD contents were significantly lower than those before operation, and serum REN, AT-II, ALD, FIB, DD, MDA and MPO contents as well as APTT and TT levels of group A were significantly lower than those of group B while TAOC and TSOD contents were significantly higher than those of group B. Conclusion: Dexmedetomidine combined with ulinastatin for acute aortic dissection can inhibit RAAS system and oxygen free radical generation and improve coagulation function.

R543.1

江苏省科技计划项目(SBE2015720130)