目的 探究右美托咪定復(fù)合依托咪酯對全麻老年大鼠肝部分切除術(shù)后認知功能障礙的改善作用。方法 雄性大鼠隨機分為對照組、模型組、右美托咪定組、依托咪酯組、右美托咪定復(fù)合依托咪酯組，每組12只。2%異氟烷麻醉后，行氣管插管機械通氣，持續(xù)吸入1.5%異氟烷。右美托咪定組麻醉誘導(dǎo)給予6 μg/kg右美托咪定10 min靜注完畢，依托咪酯組麻醉誘導(dǎo)給予1.20 mg/kg依托咪酯靜注，依托咪酯復(fù)合右美托咪定組麻醉誘導(dǎo)靜注1.20 mg/kg依托咪酯和6 μg/kg右美托咪定（10 min靜注完畢），模型組全麻氣管插管不給予任何靜脈麻醉藥物，對照組不給予任何處理。實驗組和模型組分別在全麻氣管插管藥物誘導(dǎo)后行肝部分切除術(shù)，造術(shù)后認知功能障礙的模型，對照組不予任何處理。術(shù)前1 d、術(shù)后1～5 d進行Morris水迷宮實驗，術(shù)后第6天進行空間探索測試記憶能力。取術(shù)前1 d、術(shù)后1、3、5 d大鼠尾靜脈血樣，采用酶聯(lián)免疫測定IL-6水平。結(jié)果 與模型組比較，右美托咪定組、依托咪酯組、依托咪酯復(fù)合右美托咪定組的潛伏期顯著縮短（P< 0.05）；與模型組比較，右美托咪定組、依托咪酯復(fù)合右美托咪定組穿越平臺次數(shù)顯著增加（P< 0.01），目標(biāo)象限停留時間比顯著增加（P< 0.01），IL-6水平顯著降低（P< 0.05）。結(jié)論 右美托咪定復(fù)合依托咪酯可降低老年大鼠肝部分切除術(shù)后炎癥因子水平，改善其術(shù)后認知功能。

Objective To explore the effects of dexmedetomidine combined with etomidate on cognition dysfunction in aged rats rats after partial hepatectomy. Methods Male rats were randomly divided into control group, model group, dexmedetomidine group, etomidate group, and dexmedetomidine combined with etomidate group, and each group had 12 rats. After 2% isoflurane anesthesia and the trachea was intubated and mechanically ventilated, 1.5% isoflurane was continuously inhaled. Rats in dexmedetomidine group were iv administered with 6 μg/kg dexmedetomidine within 10 min. Rats in etomidate group were iv administered with 1.20 mg/kg etomidate. Animals in combination group were iv administered with 1.20 mg/kg etomidate and 6 μg/kg dexmedetomidine within 10 min. Experimental groups and model group were treated with partial hepatectomy to establish postoperative cognitive dysfunction models after induction of tracheal intubation drug. The control group was not given any treatment. Morris water maze test was performed 1 d before operation and 1 to 5 d after operation. The memory ability was explored on the 6th day after operation. The serum levels of IL-6 were determined by enzyme-linked immunosorbent assay (ELISA). Results Compared with the model group, the latent periods in dexmedetomidine group, etomidate group, and combination group were significantly shortened (P < 0.05). Compared with the model group, the number of crossing platforms in dexmedetomidine group and combination group were significantly increased (P < 0.01), and the percentage of residence times in target quadrant were significantly increased (P < 0.01), and the levels of IL-6 were significantly decreased (P < 0.05). Conclusion Dexmedetomidine combined with etomidate can reduce the level of inflammatory factors after partial hepatectomy in aged rats and improve its postoperative cognitive function.

牡丹江醫(yī)學(xué)院研究生創(chuàng)新科研資金項目（2014YJSCX-16）