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目的 探讨右美托咪定对体外循环(C PB)瓣膜置换术患者手术前后炎性因子及肝肾功能的影响.方法 选取2012年7月至2016年7月该院行C PB瓣膜置换术患者80例,按随机数字表法分为对照组和试验组,试验组患者静脉持续泵入0.6μg/(kg·h)的右美托咪定至术毕,对照组患者给予同体积的生理盐水.检测和对比2组患者术前(T1)、阻断升主动脉前(T2)、转流停止时(T3)、术后1 d(T4)、术后2 d(T5)、术后3 d(T6)6个时间点的血中性粒细胞百分比(N%)、白细胞计数(WBC)和血清肿瘤坏死因子(TNF)-α、IL(白细胞介素)-6、高迁移率族蛋白(HMGB)-1、尿素氮(BUN)、丙氨酸氨基转移酶(ALT)、肌酐(Cr)的水平.结果 试验组患者T2~T6的N%、TNF-α、IL-6、BUN、Cr水平均低于对照组,差异有统计学意义(P<0.05);试验组患者T1~T6的WBC水平均低于对照组,差异有统计学意义(P<0.05);试验组患者T3~T6的HMGB-1水平均低于对照组,差异有统计学意义(P<0.05);试验组患者T2、T5的ALT水平均低于对照组,差异有统计学意义(P<0.05).结论 右美托咪定能够降低C PB瓣膜置换术引起的炎性反应程度,对肾脏具有保护作用,但对肝脏的保护作用不明显.“,”Objective To investigate the effect of dexmedetomidine on inflammatory factors and liver and kidney function before and after surgery of patients underwent CPB valve replacement .Methods Selected 80 cases underwent CPB valve replacement from July 2012 to July 2016 in the hospital ,who were randomly divided into control group and experimental group ,experimental group with intravenous infusion of 0 .6 μg/(kg · h) of dexmedetomidine until the end of operation .Patients in control group were given the same volume of saline .Detected and compared two groups with preoperative(T1) ,aortic anterior(T2) ,bypass stop(T3) ,after 1 day(T4) ,after 2 days(T5) ,after 3 days(T6) 6 time points of blood N% ,WBC ,IL-6 ,TNF-α,HMGB-1 ,BUN ,ALT and Cr level . Results Levels of N% ,TNF-α,IL-6 ,BUN ,Cr in T2-T6 of the experimental group was lower than those of the control group ,the difference was statistically significant (P<0 .05);Level of WBC in T1 -T6 of the experimental group was lower than that of the control group ,the difference was statistically significant (P<0 .05);Level of HMGB-1 in T3 -T6 of the experimental group was lower than that of the control group ,the difference was statistically significant (P<0 .05) .Level of ALT in T2 and T5 of the ex-perimental group was lower than that of the control group ,the difference was statistically significant (P< 0 .05) .Conclusion Dexmedetomidine can reduce the degree of inflammation caused by CPB valve replacement ,has a protective effect on the body kid-ney ,and the protective effect on the liver is not obvious .