Effects of Mazolam combined with dexmedetomidine sedation on curative effect-related indicators in elderly patients with traumatic brain injury

doi:10.19854/j.cnki.1008-2425.2022.04.0009

Abstract

Abstract: Objective To evaluate effect of remazolam combined with dexmedetomidine sedation regimen on effect-related indicators,neuronal PAS structure and protein 4 (NPAS4) and neuregulin-1 (NRG-1) of serum neurons in patients elderly patients with traumatic brain injury. Methods 120 elderly patients with traumatic brain injury who came to our hospital for treatment from January 2020 to May 2021 were selected.According to the random number method,the patients were randomly divided into 3 groups,group A,group B and group C.Patients in group A were treated with dexmedetomidine hydrochloride on the basis of conventional treatment; patients in group B were treated with remazolam on the basis of conventional treatment; patients in group C were treated with dexmedetomidine hydrochloride and remazol on the basis of conventional treatment Lun combination therapy.Hemodynamic indicators (heart rate and mean arterial pressure (MAP)),inflammatory mediators (interleukin-6 (IL-6) and C-reactive protein (CRP)) and NGR-1,NPAS4 level is tested.Results After 1 day and 3 days of treatment,the patient's heart rate and MAP decreased (P＜0.05).After treatment,the heart rate and MAP level of patients in group A and B were similar (P＞0.05),but patients in group C Compared with the other two groups,the MAP and heart rate decreased more significantly (P＜0.05); after 1 day and 3 days of treatment,the IL-6 and CRP of the two groups were lower than before treatment (P＜0.05),treatment 1 Days and 3 days later,the levels of CRP and IL-6 in group A and group B were similar (P＞0.05),but the levels of IL-6 and CRP in group C were lower than those in groups A and B (P＜0.05) ; After 1 day and 3 days of treatment,the levels of NPAS4 and NGR-1 of the three groups of patients were lower than before treatment (P＜0.05).After 1 day and 3 days of treatment,the NPAS4 of group A and group B patients The level was similar to NGR-1,but the levels of NPAS4 and NGR-1 in group C were lower than those in the other two groups (P＜0.05).Conclusion Remazolam combined with dexmedetomidine can improve the patient's hemodynamics and inflammatory mediator levels,and reduce the expression of NGR-1 and NPAS4 in patients,which has certain clinical application value.

Key words: Remazolam, Dexmedetomidine, Senile traumatic injury, Neuronal PAS structure and protein 4, Neuromodulin-1

摘要： 目的研究瑞马唑仑联合右美托咪定镇静对老年创伤性颅脑损伤患者疗效相关指标以及血清神经元PAS结构与蛋白4(neuronal PAS structure and protein 4,NPAS4)和神经调节蛋白-1(NRG-1)的影响。方法选择2020年1月到2021年5月到我院进行治疗的老年创伤性颅脑损伤患者120例,依据随机数字法将患者随机分为3组,盐酸右美托咪定组、瑞马唑仑组和联合组。盐酸右美托咪定组患者在常规治疗基础上应用盐酸右美托咪定;瑞马唑仑组患者在常规治疗基础上给予瑞马唑仑;联合组患者在常规治疗基础上,进行盐酸右美托咪定和瑞马唑仑联合治疗。对患者治疗前后血流动力学指标(心率和平均动脉压(mean arterial pressure,MAP))、炎症介质(白细胞介素-6(IL-6)和C反应蛋白(CRP))和NGR-1、NPAS4水平进行检测。结果治疗1天和3天后,患者的心率和MAP均有所降低(P＜0.05),治疗后盐酸右美托咪定组和瑞马唑仑组患者的心率和MAP水平相似(P＞0.05),但是联合组患者的MAP和心率较其它两组下降更明显(P＜0.05);治疗1天和3天后,两组患者的IL-6和CRP均较治疗前有所降低(P＜0.05),治疗1天和3天后,盐酸右美托咪定组和瑞马唑仑组两组患者的CRP和IL-6水平相似(P＞0.05),但是联合组患者的IL-6和CRP水平均低于A、瑞马唑仑组(P＜0.05);治疗1天和3天后,三组患者的的NPAS4和NGR-1水平均较治疗前有所降低(P＜0.05),治疗1天和3天后,盐酸右美托咪定组和瑞马唑仑组患者NPAS4和NGR-1水平相似,但是联合组患者的NPAS4和NGR-1水平低于其余两组(P＜0.05)。结论瑞马唑仑联合右美托咪定能够改善患者的血流动力学和炎症介质水平,降低患者NGR-1、NPAS4表达,有一定的临床应用价值。

关键词: 瑞马唑仑, 右美托咪定, 老年创伤性损伤, 神经元PAS结构与蛋白4, 神经调节蛋白-1

CLC Number:

R651

Yao Yanfen,Li Pibao,Sun Wei,et al.. Effects of Mazolam combined with dexmedetomidine sedation on curative effect-related indicators in elderly patients with traumatic brain injury[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2022, 35(4): 235-240.

姚艳粉，李丕宝，孙玮，葛均克. 瑞马唑仑复合右美托咪定镇静对老年创伤性颅脑损伤患者疗效相关指标的影响[J]. 立体定向和功能性神经外科杂志, 2022, 35(4): 235-240.

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