| Project/Area Number |
17K16730
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Multi-year Fund |
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| Research Field |
Anesthesiology
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| Research Institution | Kyoto University |
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Principal Investigator |
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| Project Period (FY) |
2017-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥3,900,000 (Direct Cost: ¥3,000,000、Indirect Cost: ¥900,000)
Fiscal Year 2018: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
Fiscal Year 2017: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
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| Keywords | 血小板 / 糖尿病 / 麻酔 / 集中治療 / デクスメデトミジン / プロポフォール / α２アドレナリン受容体 / 術後 / 集中治療室 / P-selectin / 麻酔学 |
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| Outline of Final Research Achievements |
In this study, we analyzed the effects of the α2-agonist dexmedetomidine (DEX) and the venous anesthetic propofol (PRO) on the platelet activation marker: P-selectin expression (PS) in peripheral blood collected before and after surgery from diabetic/non-diabetic patients admitted to the postoperative intensive care unit.
In non-diabetic patients, DEX enhanced PS dose-dependently, but there was no significant difference between pre- and postoperative treatment. Low concentrations of PRO enhanced PS both before and after surgery, while high concentrations of PRO inhibited PS only before surgery.
In diabetic patients, PS was higher pre- and postoperatively in both DEX and PRO than in nondiabetic patients. As in non-diabetic patients, DEX enhanced PS in a concentration-dependent manner, but it was significantly higher postoperatively than preoperatively. PRO enhanced PS at low concentrations both pre- and postoperatively, and inhibited PS at high concentrations only preoperatively.
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| Academic Significance and Societal Importance of the Research Achievements |
糖尿病患者の血小板に特徴的な機能亢進したα2アドレナリン受容体と鎮静薬/麻酔薬の関係性、手術侵襲と麻酔薬の血小板P-セレクチン発現への影響については従来報告がなく、本研究によって周術期に血小板P-セレクチン発現レベルを解析することの意義が初めて示された。これらの成果により、周術期管理における血小板機能変化の意義がさらに明らかになり、より最適な糖尿病患者の周術期管理方法の開発応用が期待される。
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