Effects Of Dexmedetomidine On Peripheral Blood Lymphocyte Subsets And Inflammatory Response In Children With Sepsis

Sepsis is Systemic inflammatory response syndrome?SIRS?with large quantities of bacterial toxins entering the circulation caused by various pathogeninfections.According to the severity of the division divided into sepsis,severe sepsis,septic shock.Children as a result of immune function is low,systemic each organ system development is often rapid,progress is rapid,easy to appear septic shock,causesystemic many viscera failure even,case fatality is very high.Studies have shown that dexmedetomidine has anti-inflammatory,immunomodulatory and organ protective effects in addition to sedation and analgesia,but its application in children has been rarely reported.This study intends to observe the effect of dexmedetomidine onperipheral blood lymphocyte subsets and inflammatory factors in children with sepsis.Obective:To explore the effects of dexmedetomidine on peripheral blood lymphocyte subsets and inflammatory responses in children with sepsis.Methods:Sixty children with sepsis who underwent surgical treatment in our hospital from June 2017 to August 2018 were selected,Seven months to ten years old,ASA class?-?,divided into two groups by random number table method?n=30?,the right beauty microphones set group?group D?and the control group?group C?.Group D was pumped with dexmedetomidine at 1ug/kg for 15min before anesthesia induction,and then maintained at 0.5ug/kg/h until 5min before the end of surgery.Group C was pumped with the same amount of normal saline.Two ml venous blood samples were taken 24h after surgery to detect the lymphocyte subsets in the two groups.2ml of venous blood was taken from the children before and 24 hours after the operation,and the levels of il-1?interleukin-1?,il-6?interleukin-6?and tnf-alpha?tumor necrosis factor-alpha?inflammatory factors were detected in the two groups.Heart rate?HR?,mean arterial pressure?MAP?and blood oxygen saturation?SpO₂?were recorded at the time of entry?T0?,intubation?T1?,5min after operation?T2?,and at the end of operation?T3?.The data were analyzed by SPSS23.0,in which the counting data were expressed as rate?%?,the X² test was performed,and the measurement data were expressed as?x?±s?,and the t test was performed.P<0.05 indicated statistical significance.Results:?1?There was no statistically significant difference in general condition?age,weight,gender?between the two groups?P>0.05?.?2?Comparison of postoperative lymphocyte subsets between the two groups:CD3+,CD3+CD4+,CD3+CD8+,CD19+,CD4+/CD8+ratios in group D were higher than those in group C?P<0.05?,while CD16+CD56+in group D was lower than that in group C?P<0.05?.?3?There was no statistically significant difference in preoperative inflammatory factors between the two groups?P>0.05?,and the levels of il-1,il-6 and tnf-alpha in group D 24hours after surgery were lower than those in group C?P<0.05?.?4?There were no significant fluctuations in perioperative heart rate,average arterial pressure in group D.Only T1 and T0,T2 and T0 showed statistical differences,while no statistical differences were found in other groups?P>0.05?.There were significant fluctuations in various indexes after drug anesthesia in group C,and there were statistically significant differences in the data between groups T1 and T0,T2 and T0,T3 and T0,T2 and T1?P<0.05?.There were differences in the anesthesia effect between the two groups,and the anesthesia effect was better in group D.Conclusion:All this studies showed that Intravenous infusion of dexmedetomidine can improve the level of peripheral blood lymphocyte subsets,and reduce the level of inflammatory factors in children with sepsis,which is worthy of clinical application.