The research of protective effects of alprostadil combined with dexmedetomidine preconditioning on skeletal muscle ischemia reperfusion and secondary lung injuries / 重庆医学

ABSTRACT

Objective To investigate the protective effects of combination alprostadil and dexmedetomidine preconditioning treatment on skeletal muscle ischemia reperfusion and secondary lung injuries.Methods Sixty patients aged less than 70 years old undergoing unilateral lower extremity surgery were randomly assigned into four groupscontrol group(group A),dexmedetomidine group(group B),alprostadil group(group C)and combined treatment group(group D) with 15 cases in each.In group C and D,10 μg alprostadil was given from vein at 15 min before tourniquet inflation,in group B and D 1 μg/kg dexmedetomidine was given from vein at 10 min before tourniquet inflation,the equal volume of normal saline was infused in control group.The blood samples were drawn from vein and artery for blood gas analysises and determination of malondialdehyde(MDA) and human pulmonary surfactant specific protein D (SP D) concentrations at the time before oxygen inhalation(T1),2 h after tourniquet deflation(T2),6 h after tourniquet deflation(T3) respectively.Results In group B,C and D,the alveolar arterial oxygen pressure difference(PA-a DO2)and respiratory index(R1) were significantly lower than those in group A at T2(P＜0.05).PA-aDO2 and R1 were significantly higher at T3 than those at T1 in every groups(P＜0.05);In group B,C and D,MDA and SP D were significantly lower than those in group A at T2 and T3(P＜0.05).In group D,MDA and SP D were significantly lower than those in group B and group C at T3(P＜0.05).Conclusion Alprostadil and dexmedetomidine are infused from vein preconditioning can attenuate the damages of skeletal muscle ischemia reperfusion and secondary lung injuries.The combination of alprostadil with dexmcdetomidine can produce stronger effects.