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目的 观察右美托咪定(Dex)对非体外循环冠状动脉搭桥术(OPCABG)患者的心肌保护作用.方法 选取择期行OPCABG患者60例(ASAⅡ～Ⅲ级),随机分为右美托咪定组(观察组)和对照组各30例.两组麻醉诱导药物相同,观察组于入室后输注Dex负荷剂量1.0μg/kg,继以0.5μg/kg/h的速率维持至术毕,对照组用相同方式输注生理盐水.分别于入室后10min(T0)、手术开始(T1)、术毕5min时(T2)及术毕12h(T3),抽取中心静脉血3ml离心分离血清,采用双抗体夹心-酶联免疫分析(ELISA)法定量测定血清中TNF-α、IL-6、IL-10以及cTnI的含量.结果 TNF-a、IL-6和cTnI在T0和T1时点观察和对照两组比较差异无统计学意义(P＞0.05),在T1时点观察组的IL-10水平高于对照组(P＜0.05).在T2和T3时点观察组TNF-α和cTnI的水平均低于对照组(P＜0.01),观察组IL-10水平均高于对照组(P＜0.01).观察组IL-6水平分别低于对照组(P＜0.01和P＜0,05).结论 右美托咪定通过减弱炎症反应和增强抗炎症反应,减轻OPCABG患者的心肌组织损伤,对心肌起到一定的保护作用.“,”Objective To study the myocardial protection effect of dexmedetomidine in patients undergoing off -pump coronary artery bypass graft surgery (OPCABG).Methods Sixty patients (ASA Ⅱ ～ Ⅲ) undergoing OPCABG were randomly divided into two groups:dexmedetomidine group (n =30) and the control group (n =30).The same drugs of anesthetic induction were treated in two groups.Dexmedetomidine was given at a loading dose of 1.0 μg/kg to patients in group D,and then infused continuously at a rate of 0.5μg/(kg.h).The same programme infusion of saline was given in group C,3ml venous blood specimen were taken for separating serum at 10 min after entering the operation room (T0),the beginning of the operation (T1),5 min after the operation (T2) and 12h after the operation (T3),and then the double antibodies sandwich-enzymelinked immunosorbent assay (ELISA) was conducted to detecte the content of TNF-α,IL-6,IL-10 and cTnI in serum.Results At T0 and T1,there were not significant difference in the concentrations of TNF-α,IL-6 and cTnI in serum between the two groups (P＞0.05),and the concentration of IL-10 in serum of group D was significantly higher than group C at T1 (P＜0.05).At T2 and T3,the concentration of TNF-α and cTnI in serum of group D were extremely significantly lower than group C (P ＜0.01),the concentration of IL-10 in serum of group D were extremely significantly higher than group C (P＜0.01),the concentration of IL-6 in serum of group D were respectively extremely significantly (P＜0.01) and significantly (P＜0.05) lower than group C.Conclusion Dexmedetomidine can decrease the inflammation responses and enhancing the anti -inflammatory responses caused by OPCABG,reduce the myocardial injury and improve the cardiac function of the patients.