目的 探究右美托咪定复合依托咪酯对全麻老年大鼠肝部分切除术后认知功能障碍的改善作用。方法 雄性大鼠随机分为对照组、模型组、右美托咪定组、依托咪酯组、右美托咪定复合依托咪酯组，每组12只。2%异氟烷麻醉后，行气管插管机械通气，持续吸入1.5%异氟烷。右美托咪定组麻醉诱导给予6 μg/kg右美托咪定10 min静注完毕，依托咪酯组麻醉诱导给予1.20 mg/kg依托咪酯静注，依托咪酯复合右美托咪定组麻醉诱导静注1.20 mg/kg依托咪酯和6 μg/kg右美托咪定（10 min静注完毕），模型组全麻气管插管不给予任何静脉麻醉药物，对照组不给予任何处理。实验组和模型组分别在全麻气管插管药物诱导后行肝部分切除术，造术后认知功能障碍的模型，对照组不予任何处理。术前1 d、术后1～5 d进行Morris水迷宫实验，术后第6天进行空间探索测试记忆能力。取术前1 d、术后1、3、5 d大鼠尾静脉血样，采用酶联免疫测定IL-6水平。结果 与模型组比较，右美托咪定组、依托咪酯组、依托咪酯复合右美托咪定组的潜伏期显著缩短（P< 0.05）；与模型组比较，右美托咪定组、依托咪酯复合右美托咪定组穿越平台次数显著增加（P< 0.01），目标象限停留时间比显著增加（P< 0.01），IL-6水平显著降低（P< 0.05）。结论 右美托咪定复合依托咪酯可降低老年大鼠肝部分切除术后炎症因子水平，改善其术后认知功能。

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.

牡丹江医学院研究生创新科研资金项目（2014YJSCX-16）