Study On The Changes Of HMGB1 And SRAGE In Peripheral Blood Of Patients With Sepsis ARDS By Dexmedetomidine

Objective:Dexmedetomidine is a commonly used sedative drug in the ICU.By maintaining the same depth of sedation as the traditional intravenous sedative midazolam,the clinical application of dexmedetomidine is explored for the treatment of soluble advanced glycosylation end products in patients with ARDS.SRAGE and high mobility group protein B-1(HMGB-1),to explore its lung protective effect on sepsis ARDS.Methods:30 patients with sepsis and ALL who were admitted to the Department of Intensive Medicine of the Fourth Affiliated Hospital of Kunming Medical University from March 2019 to January 2020 were selected.Random number table method was used to divide the research subjects into dexmedetomidine group(experimental group)and midazolam group(control group),15 people in each group.Record the age,gender,underlying disease and APACHE ? score of the two groups of patients.The dexmedetomidine group was not given a loading dose,and was intravenously infused after dilution,intravenously at an initial rate of 0.4 ug/kg/h,Adjust the pumping rate in the range of 0.2-0.7ug/kg/h according to the sedation;intravenous infusion of midazolam after dilution,intravenous injection at the initial rate of 0.1mg/kg/h,according to the patient's sedation in the range of 0.03-The pump injection speed was adjusted within the range of 0.2mg/kg/h;the RASS sedation score of the two groups was maintained between-2-0 points.Record the changes of PCT,CPR,HMGB1,and sRAGE at various time points for patients entering T0(entrance),T1(12h),T2(24h),T3(48h).Analysis of variance using repeated measurements of SPSS22.0 software for statistical analysis between and within groups,P?0.05 in this study is considered statistically significant.Results:At the time of enrollment,the basic data and APACHE ? scores of the two groups were not statistically significant(P?0.05).Combined with the interactive graph,it can be seen that the concentration of PCT,CRP,HMGB1,and sRAGE in the two groups changed with time,and the change with time between the two groups was statistically significant(P?0.05).The PCT,CRP,The concentration of HMGB1 and sRAGE decreased faster.Combined with the interactive graph,it can be seen that the OI values of the two groups of patients are increasing,but the comparison between the two groups is not statistically significant(P?0.05).Conclusion:Compared with the midazolam group at the same depth of sedation,dexmedetomidine can reduce serum PCT,CRP,HMGB1,and sRAGE levels in patients with sepsis and ARDS.The mechanism may be to reduce the acute lung injury by reducing the expression of HMGB1 and inhibiting the RAGR pathway.