Influence of dexmedetomidine to inflammatory cytokines in mechanical ventilation for patients with acute exacerbation of COPD
10.3760/cma.j.issn.1008-6706.2018.22.001
- VernacularTitle:右美托咪定对机械通气慢性阻塞性肺疾病急性加重期患者炎性因子的影响
- Author:
Xiandan WU
1
;
Xiaoqin LIN
;
Jinbo ZHANG
;
Xiaohong JIN
;
Jinqiang ZHU
;
Meiping DONG
;
Liexiang CAO
;
Laicao YAN
Author Information
1. 温州医科大学附属温岭医院 温岭市第一人民医院急救中心
- Keywords:
Dexmedetomidine;
Pulmonary disease;
chronic obstructive;
Ventilators;
machanical;
Respiration;
artificial;
Tumor necrosis factor-αlpha;
Interleukin1;
C reactive protein
- From:
Chinese Journal of Primary Medicine and Pharmacy
2018;25(22):2857-2860
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the effects of dexmedetomidine(Dex) on levels of inflammatory cytokines in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods From April 2015 to April 2017,94 patients with acute exacerbations of COPD who received mechanical ventilation in Wenling Hospital Affiliated to Wenzhou Medical College were randomly divided into two groups according to the digital table,with 47 cases in each group. Group A was given Dex,and group B was given midazolam. The levels of TNF - α,IL - 1, hs - CRP between the two groups were compared. Results There were no statistically significant differences in TNF - α,IL - 1,hs - CRP between the two group before treatment (all P > 0. 05). One day after treatment,the levels of TNF - α,IL -1,hs - CRP in group A were (92. 99 ± 15. 25)ng/ L,(68. 63 ± 14. 53)ng/ L,(15. 44 ± 4. 92)mg/ L, respectively,which in group B were (150. 63 ± 20. 78)ng/ L,(91. 13 ± 12. 58)ng/ L,(19. 35 ± 5. 17)mg/ L,respec-tively,there were statistically significant differences between the two groups(t = 2. 736,2. 503,2. 421,P = 0. 008, 0. 012,0. 015). Three days after treatment,the levels of TNF - α,IL - 1,hs - CRP in group A were (73. 37 ± 11. 01)ng/ L,(51. 52 ± 9. 16) ng/ L, (14. 82 ± 3. 29) mg/ L, respectively, which in group B were (123. 80 ± 19. 62)ng/ L,(73. 46 ± 17. 36) ng/ L, (18. 77 ± 4. 02 ) mg/ L, respectively, there were statistically significant differences between the two groups(t = 2. 184,2. 354,2. 098,P = 0. 031,0. 022,0. 039). Five days after treatment, the levels of TNF - α,IL - 1,hs - CRP in group A were (63. 54 ± 13. 06)ng/ L,(34. 04 ± 8. 13) ng/ L,(13. 84 ± 4. 13)mg/ L,respectively,which in group B were (76. 63 ±17. 39)ng/ L,(50. 66 ± 9. 17)ng/ L,(14. 27 ± 3. 95)mg/ L, respectively,there were statistically significant differences between the two groups( t = 1. 906,2. 082,1. 834,P =0. 067,0. 041,0. 081). Compared with group B,the ICU time in group A was significantly decreased[(9. 27 ± 1. 63) d vs. (7. 16 ± 1. 21)d,t = 2. 215,P = 0. 031](t = 2. 215,P = 0. 031). There was no statistically significant difference in the incidence rate of multiple organ dysfunction syndrome between the two groups at 5 days after treatment (χ2 =2. 286,P = 0. 132). Conclusion Dex can effectively inhibit inflammation cytokines of the mechanical ventilation COPD patients in acute exacerbation,and can reduce the ICU time.
