中国免疫学杂志2017,Vol.33Issue(11):1694-1698,5.DOI:10.3969/j.issn.1000-484X.2017.11.020
右美托咪定对结肠癌根治术患者围术期应激反应及细胞免疫功能的影响
Effect of dexmedetomidine on stress response and cellular immune function in patients undergoing radical resection of colon cancer
摘要
Abstract
Objective:To investigate the effect of dexmedetomidine on stress response and cellular immune function in patients undergoing radical resection of colon cancer during perioperative period.Methods: 96 cases of colon cancer undergoing radical resection were randomly divided into dexmedetomidine group(group D)and control group(group C).The group D was intubated with in-travenous infusion of dexmedetomidine 0.6 μg/kg,followed by intravenous infusion of 0.3 μg/(kg·h) at the end of the surgery,and the group C was given 0.9% saline at equal volume and rate.The venous blood of patients was collected before anesthesia induction,10 min(T0),immediate postoperative(T1),postoperative 24 h(T2)and postoperative 72 h(T3).Flow cytometry were used to detect T lym-phocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+)and the percentage of NK cells,and determination of norepinephrine(NE), epinephrine(E),cortisol(Cor),IL-6,IL-10 and TNF-α levels.Records of patients with T0,immediate intubation(Ta),T1,immediate extubation(Tb)of SBP,DBP,MAP,and postoperative adverse reactions were recorded.Results:The SBP,DBP and MAP of group C at Ta,T1,Tbwere significantly higher than that of T0and group D(P<0.05).Compared to those at T0,the levels of CD3+,CD4+,CD8+and CD4+/CD8 at T1and T2were significantly lower in both groups(P<0.05),and the levels of group C at T1,T2,T3were significantly lower than those in group D(P<0.05).The NK cells of group C at T1,T2were significantly lower than that of T0and group D(P<0.05).Compared to those at T0,the levels of IL-6,IL-10 and TNF-α at T1and T2were significantly higher in both groups(P<0.05), and the levels in group C were significantly higher than those in group D(P<0.05).The IL-6 and IL-10 of group C at T3were significantly higher than that of T0and group D(P<0.05).Compared to those at T0,the levels of NE,E and Cor at T1and T2were sig-nificantly higher in both groups(P<0.05),and the levels in group C were significantly higher than those in group D(P<0.05).The NE,E and Cor of group C at T3were significantly higher than that of T0and group D(P<0.05).The proportion of adverse reactions in group D was significantly lower than that in group C(χ2= 4.800,P= 0.028).Conclusion: Dexmedetomidine can inhibit the perioperative stress response and reduce the impact on immune function in patients undergoing radical resection of colon cancer.关键词
右美托咪定/结肠癌/应激反应/免疫功能Key words
Dexmedetomidine/Colon cancer/Stress response/Immune function分类
医药卫生引用本文复制引用
周志鹏,宋歌,王航,蔡仁贤..右美托咪定对结肠癌根治术患者围术期应激反应及细胞免疫功能的影响[J].中国免疫学杂志,2017,33(11):1694-1698,5.基金项目
本文受海南省医学科研基金资助(15812560). (15812560)