Objective:To explore the effect of dexmedetomidine on myocardial oxygen supply‐demand balance in elderly patients with coronary heart disease during pulmonary lobectomy .Methods:Forty elderly patients with coronary heart disease , aged from 60 to 70 ,who were going to undergo pulmonary lobectomy with general anesthesia and were graded as II‐III with American society of Anesthesiologists (ASA ) criteria , were enrolled in the study . They were randomly divided into dexmedetomidine group (Group D) and 0 .9% sodium chloride injection group (Group N) ,with 20 cases in each group .At 30 minutes before anesthesia induction ,dexmedetomidine was infused by 1 .0μg/kg within 10‐15 minutes ,and then maintained by 0 .3 μg/(kg · h) till 40 minutes before operation ,in Group D .In Group N ,0 .9% sodium chloride injection was given by the same method .Systolic blood pressure(SBP) and heart rate(HR) were recorded ,while blood gas analysis were conducted with 1 mL blood from radial artery and 1 mL blood from pulmonary artery to calculate the oxygen supply (DO2 ) , oxygen consumption (VO2 ) and rate‐pressure product (RPP) ,before anesthesia (T0) ,15 min after the onset of anesthesia (T1) ,at intubation (T2) ,at the end of operation (T3) ,at extubation (T4) ,respectively .Results:Compared with Group N ,HR and SBP ,RPP and VO2 at T1 ~ T4 were lower in Group D , and the differences were statistically significant ( P< 0 .05 ) . Conclusions :Dexmedetomidine can reduce myocardial oxygen consumption in elderly patients with coronary heart disease during pulmonary lobectomy ,which is conductive to reduce adverse cardiac events .%目的：探讨右美托咪定（DEX ）对老年冠心病患者肺叶切除术中心肌氧供需平衡的影响。方法：选择拟在全麻下行肺叶切除术的60～70岁老年冠心病患者40例，美国麻醉医师协会（ASA ）分级Ⅱ～Ⅲ级，随机分为右美托咪定组（D组）与0．9％氯化钠注射液组（N组），每组20例。麻醉诱导前30 min ，D组给予右美托咪定（1μg／kg ），静脉注射10～15 min ，之后维持0．3μg／（kg · h）至手术结束前约40 min；N 组以相同方式给予等剂量的0．9％氯化钠注射液。分别在全麻诱导前30 min （T0）、麻醉用药后15 min（T1）、气管插管即刻（T2）、手术结束时（T3）、拔管后即刻（T4）时，记录两组患者的收缩压（SBP）、心率（HR），并抽取桡动脉血与肺动脉血各1 mL ，进行血气分析，计算氧供（DO2）、氧耗（VO2）和心率收缩压乘积（RPP）。结果：与N组比较，D组T1～T4时间点 HR、SBP、RPP、VO2均较低，差异均有统计学意义（P＜0．05）。结论：右美托咪定可以显著降低老年冠心病患者肺叶切除术中的心肌氧耗，从而有利于减少心脏不良事件的发生。
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