Effect Of Dexmedetomidine On Renal Function Of Patients Undergoing Cardiopulmonary Bypass Valve Replacement

Objective: To observe the effect of dexmedetomidin on renal function in patients with cardiac valve replacement under cardiopulmonary bypass.Methods: 108 patients with rheumatic valvular heart disease underwent aortic valve and mitral double valve replacement were as research subjects from July 2015 to July 2016 in our hospital.They were divided into the control group(n=54)and the study group(n=54)according to the random number table method.During anesthesia,the patients in the study group received intravenous injection of dexmedetomidine hydrochloride injection 0.5?g/kg and continued to pump at0.5?g/kg/h until the end of operation.The control group was treated with equal volume of normal saline instead of dexmedetomidine hydrochloride injection.Patient's medical records were collected.Venous blood was extracted before anesthesia induction,6h,12 h,24h,48 h and 72 h after operation,the levels of serum creatinine(Scr),urea nitrogen(BUN)and cystatin C(Cys C)were detected.The difference of Scr,BUN and Cys C levels in two groups of patients at different time points were analyzed,and the correlation between the changes of serum Scr,BUN and Cys C and the occurrence of acute renal function injury(AKI)after operation were statistically analyzed.Results: Two groups of patients with serum Scr,BUN and Cys C levels after operation respectively 48 h,24h and 12 h reached the maximum value,then decreased gradually;and after valve replacement under cardiopulmonary bypass 6h,12 h,24h,48 h and 72 h each time point of investigation,serum Scr,BUN and Cys C levels were significantly lower than the control group,and the differences were statistically significant(P<0.05).The elevated serum Scr,BUN and Cys C levels were all related risk factors for AKI(P<0.05),and they all had strong correlation(OR=2.827,2.605 and 3.024).Conclusion: external circulating cardiac valvular Scr,BUN and Cys C levels increased after operation and is closely related to the occurrence and development of AKI,dexmedetomidine can significantly lower cardiac valvular postoperative serum Scr,BUN and Cys C levels,reduce the degree of renal injury patients,can effectively prevent the occurrence of AKI clinical workers should be paid attention to.