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[目的]评价右美托咪定在心脏瓣膜置换手术中的神经保护作用.[方法]100例心脏瓣膜置换术患者随机分为观察组和对照组(n=50).观察组在常规麻醉诱导前10 min内静脉注射右美托咪定10.μg/kg,之后以05.μg/(kg·h)静脉输注至术毕;对照组给予等量的生理盐水.在体外循环开始前即刻(T1)、升主动脉开放即刻(T2)、体外循环结束后10 min(T3)、术后6 h(T4),术后24 h(T5)时记录颈静脉血氧饱和度(SjvO2)、动脉-颈内静脉血氧含量差(Da-jvO2)及脑氧摄取率(CERO2),并测定2组血浆S-100β蛋白及神经元特异性烯醇化酶(NSE)水平.[结果]与T1时间点相比,观察组和对照组SjvO2显著升高,CERO2明显降低,S-100β和NSE水平明显升高(均P<00.5).在T2和T3时间点,观察组的SjvO2明显高于对照组,Da-jvO2、CERO2、S-100β蛋白以及NSE明显低于对照组(均P<00.5).[结论]右美托咪定可以改善手术中的脑氧代谢,降低脑缺血缺氧状态,并在一定程度上具有神经保护作用.“,”[Objective]To evaluate Dexmedetomidine for its cerebral protective effects during anesthesia of heart valve replacement surgery .[Methods] A total of 100 patients undergoing heart valve replacement under ex-tracorporeal circulation were randomly divided into the observation group and the control group ( n =50) .Patients in the observation group received intravenous infusion of dexmedetomidine (10.μg/kg) 10 min before the induction of conventional anesthesia ,followed by intravenous infusion of 05.μg/(kg · h) to the end of surgery .The control group received the same procedure with the same amount of saline .Carotid venous blood oxygen saturation (jugu-lar venous oxygen saturation ,SjvO2 ) ,internal jugular venous blood oxygen content (arterial venous oxygen con-tent difference ,Da-jvO2 ) and cerebral oxygen uptake rate (cerebral extraction of oxygen ,CERO2 ) were recorded at the following time points :immediately before the start of extracorporeal circulation (T1 ) ,opening the ascend-ing aorta (T2 ) ,10 min after extracorporeal circulation ending (T3 ) ,6 h after surgery (T4 ) and 24 h after surgery (T5 ) .Meanwhile serum S-100βprotein and neuron specific enolization enzyme (neuronspecific enolase ,NSE) level were measured as well .[Results] Compared to T1 time point ,levels of SjvO2 and S-100β,NSE at other time points was significantly increased in both the observation group and the control group ,while CERO2 was signifi-cantly decreased ( P <00.5) .At T2 and T3 ,SjvO2 was significantly higher in the observation group than in the control group .Da-jvO2 ,CERO2 ,S-100βprotein and NSE were significantly lower than in the control group (all P<00.5)[.Conclusion]Dexmedetomidine can improve cerebral oxygen metabolism ,reduce cerebral ischemia and hy-poxia and ,to some extent ,provide neuroprotective effectsduring anethesia of heart valve replacement surgery .