右美托咪定对机械通气脓毒症患者肝功能的影响

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中图分类号：R631 文献标志码：A DOI：10.3969/j.issn.1003-1383.2026.02.005

Effect of dexmedetomidine on hepatic function in septic patients undergoingmechanical ventilation

GUO Lisha ， XU Shuying （Department of Emergency，Afliated Hospital of Binzhou Medical College，Binzhou 2566O3，Shandong，China）

【Abstract】ObjectiveTo investigate the efects ofdexmedetomidine-based sedation protocolonliverfunction and 28-day al-causein-hospitalmortalityinsepticpatientsundergoingmechanicalventilation，soastoprovideevidence-basedsupport foroptimizing sedationstrategies insuchpatients.MethodsAtotalof88septic patientsundergoing mechanical ventilation admitedtotheEmergency IntensiveCare Unit （EICU）of Afiliated Hospital of Binzhou Medical Collge fromJuly2023 to June2024 wereenrolled.Theyweredivided intoobservation group（44cases，treated with dexmedetomidinesedation protocol）andcontrol group（44cases，treated with midazolamsedation protocol）using arandom number table.The levels of alanine aminotransferase（ALT），aspartate aminotransferase（AST），total bilirubin（TBIL），lacticacid（Lac），sequential organ failure assessment （SOFA）scores，acute physiology and chronic health evaluation II （APACHE II）scores，and 28- dayall-causein-hospital mortalitywere compared betweenthetwo groupsbefore treatmentand7daysafter treatment.Results7 days after treatment，the SOFA scores and APACHE I scores in both groups were significantly lower than those before treatment （ P<0.05 ），and the improvement in the observation group was beter than that in the control group （ P< （204号 0.05）．The levelsof ALT，AST，TBIL，andLacinboth groupsdecreased significantlycompared to those before treatment 0 （P<0.05） ，with the observation group showing a more significant decrease （ P<0. 05 ）. The 28-day all-cause in-hospital mortality of the observation group within 28 days was ）.09% ，significantly lower than that of the control group（29.55 % ） （2 （χ2=5.906，P=0.015） .ConclusionDexmedetomidine-based sedation protocol can significantly improve liver function indexesandreduce28-dayallcause in-hospital mortalityinseptic patientsundergoing mechanical ventilation，andhas potentialformuli-organfunctionprotection.However，itsspecificmechanismofactionandlong-termeficacystillneedtobefur therverified bylarge-sample prospective studies.

【Keywords】sepsis；mechanical ventilation； dexmedetomidine； liver function protection； mortality

脓毒症是一种因宿主对感染反应失调而危及生命的病症，全球发病率和病死率较高，美国每年超过150 万患者患病，全球病死率约 25%[1] 。（剩余6776字）