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目的：探讨右美托咪定对下肢缺血‐再灌注（I‐R ）损伤的影响。方法择期腰‐硬联合麻醉下行膝关节镜下膝关节清理术患者60例随机均分为两组：D组10 min内静脉泵入右美托咪定1μg／kg ，继以0.5μg · kg‐1· h‐1维持至手术结束前30 min ；C组不用右美托咪定作为对照。连续监测MAP和ECG ，检测术前（T1）、术后第1天（T2）及术后第5天（T3）血浆髓过氧化物酶（MPO）和细胞间黏附分子1（ICAM‐1）浓度。结果止血带放气后，两组MAP均较术前降低，但D组的MAP高于C组（ P＜0．05）。止血带放气后，D组心律失常发生率6.7％（2／30），低于C组的13.3％（4／30）（P＜0．05）。T2和T3时，D组血浆MPO低于C组[（41.9±12.2）μg／L vs ．（50.1±15.3）μg／L和（39.0±11.1）μg／L vs ．（48.1±17.0）μg／L]（P＜0．01）；T2和 T3时，D组血清 sICAM‐1浓度均低于C组[（380±94）pg／Lvs．（450±120）pg／L和（360±57）pg／L vs．（380±85）pg／L]（P＜0．01）。结论右美托咪定对止血带引起的下肢I‐R损伤有一定保护作用。“,”Objective To study the effect of dexmedetomidine on ischemia‐reperfusion (I‐R ) injury of the legs .Methods Sixty patients undergoing knee joint debridement under spinal‐epidural anesthesia were equally randomized into two groups .The patients in group D were infused dexmedetomidine 1μg/kg in 10 minutes ,which was followed by indusion of dexmedetomidine 0.5μg · kg‐1 · h‐1 till 30 minutes before the end of surgery .The patients in group C were not given dexmedetomidine as the controls .The MAP and ECG were monitored .Plasma myeloperoxidase(MPO) and intercellular adhesion molecule‐1(ICAM‐1) were measured before (T1) and on the 1st (T2) and 5th (T3 ) day after operation .Results After deflation of tourniquet ,MAP of two groups was decreased ,but MAP was higher in group D than that in group C (P<0 .05) and the incidence of arrhythmias was lower in group D than that in group C(6.7% vs .13.3% )(P<0 .05) .At T2 and T3 , plasma concentrations of MPO were lower in group D than those in group C[(41.9 ± 12.2)μg/L vs . (50.1 ± 15.3)μg/L and (39.0 ± 11.1)μg/L vs .(48.1 ± 17.0)μg/L](P<0 .01) .So did serum levels of sICAM‐1[(380 ± 94) pg/L vs .(450 ± 120) pg/L and (360 ± 57) pg/L vs .(380 ± 85) pg/L] (P<0 .01) .Conclusion Dexmedetomidine has a certain protective effect on tourniquet‐induced I‐R injury of the legs .