右美托咪定联合地佐辛对腹腔镜卵巢癌根治术患者肿瘤因子、免疫功能水平及相关血清因子的影响
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摘要
目的:探讨右美托咪定联合地佐辛对腹腔镜卵巢癌根治术患者肿瘤因子、免疫功能水平及相关血清因子的影响。方法:将我院诊治并拟行腹腔镜卵巢癌根治术的120例患者作为观察对象随机分为对照组和实验组。对照组麻醉采用地佐辛,实验组麻醉采用右美托咪定联合地佐辛。检测并比较两组手术前后血清人附睾蛋白4(HE4)、甲壳质酶蛋白40(YKL-40)、恶性肿瘤特异性生长因子(TSGF)、神经元特异性烯醇化酶(NSE)、S100β蛋白、丙二醛(MDA)、超氧化物歧化酶(SOD)水平及外周血CD3~+、CD4~+、CD8~+并计算CD4~+/CD8~+。结果:手术前,两组血清HE4、YKL-40、TSGF、NSE、S100β蛋白、MDA、SOD水平比较,差异无统计学意义(P>0.05);手术后,两组血清HE4、YKL-40、TSGF、NSE、S100β蛋白、MDA、SOD水平与同组手术前比较,差异具有统计学意义(P<0.05);且手术后实验组各指标改善情况优于对照组,差异具有统计学意义(P<0.05);手术前,两组外周血CD3~+、CD4~+、CD8~+水平及CD4~+/CD8~+之间比较,差异无统计学意义(P>0.05);手术后,两组外周血CD3~+、CD4~+水平及CD4~+/CD8~+与同组手术前比较,差异具有统计学意义(P<0.05);且手术后实验组各项考察指标的水平改善程度优于对照组,差异具有统计学意义(P<0.05)。结论:右美托咪定联合地佐辛能够明显降低腹腔镜卵巢癌根治术患者血清HE4、YKL-40、TSGF、NSE、S100β蛋白等肿瘤细胞因子水平,减轻氧化应激反应,且对细胞免疫功能的影响较小。
Objective: To study the effects of dexmedetomidine combined with dezocine on tumor factors, immune function levels and related serum factors in patients with laparoscopic surgery for ovarian cancer. Methods: To select 120 cases of laparoscopic ovarian cancer treated and planned to undergo laparoscopic radical operation in our hospital were randomly and equally divided into control group and treatment group. The patients in control group were treated with dezocine, the treatment group were treated with dexmedetomidine combined with dezocine. To detect and compare the serum HE4, YKL-40, TSGF, NSE, S100β protein, MDA, SOD and peripheral blood CD3~+, CD4~+, CD8~+ and calculate CD4~+/CD8~+ before and after operation. Results: Before the surgery, there was no significant difference in serum HE4, YKL-40, TSGF, NSE, S100β protein, MDA and SOD between the two groups(P>0.05). After surgery, there were significant differences between the two groups in serum HE4, YKL-40, TSGF, NSE, S100β protein, MDA and SOD levels and the same group before surgery(P<0.05), the improvement of each index in the treatment group was better than those in the control group, and the differences were significantly(P<0.05). Before the surgery, the differences between the two groups in peripheral blood CD3~+, CD4~+, CD8~+ and CD4~+/CD8~+ had no significant difference(P>0.05), After surgery, the differences between the two groups and the same group before operation in peripheral blood CD3~+, CD4~+, CD8~+ levels and CD4~+/CD8~+ were significantly(P<0.05), the improvement of each index in the treatment group was better than that in the control group, the differences were significantly(P<0.05). Conclusion: Dexmedetomidine combined with dezocine can reduce the serum HE4, YKL-40, TSGF, NSE, S100β protein levels in patients with ovarian cancer after laparoscopic operation, reduce the oxidative stress reaction, has smaller effect on cellular immune function.
Objective: To study the effects of dexmedetomidine combined with dezocine on tumor factors, immune function levels and related serum factors in patients with laparoscopic surgery for ovarian cancer. Methods: To select 120 cases of laparoscopic ovarian cancer treated and planned to undergo laparoscopic radical operation in our hospital were randomly and equally divided into control group and treatment group. The patients in control group were treated with dezocine, the treatment group were treated with dexmedetomidine combined with dezocine. To detect and compare the serum HE4, YKL-40, TSGF, NSE, S100β protein, MDA, SOD and peripheral blood CD3~+, CD4~+, CD8~+ and calculate CD4~+/CD8~+ before and after operation. Results: Before the surgery, there was no significant difference in serum HE4, YKL-40, TSGF, NSE, S100β protein, MDA and SOD between the two groups(P>0.05). After surgery, there were significant differences between the two groups in serum HE4, YKL-40, TSGF, NSE, S100β protein, MDA and SOD levels and the same group before surgery(P<0.05), the improvement of each index in the treatment group was better than those in the control group, and the differences were significantly(P<0.05). Before the surgery, the differences between the two groups in peripheral blood CD3~+, CD4~+, CD8~+ and CD4~+/CD8~+ had no significant difference(P>0.05), After surgery, the differences between the two groups and the same group before operation in peripheral blood CD3~+, CD4~+, CD8~+ levels and CD4~+/CD8~+ were significantly(P<0.05), the improvement of each index in the treatment group was better than that in the control group, the differences were significantly(P<0.05). Conclusion: Dexmedetomidine combined with dezocine can reduce the serum HE4, YKL-40, TSGF, NSE, S100β protein levels in patients with ovarian cancer after laparoscopic operation, reduce the oxidative stress reaction, has smaller effect on cellular immune function.
引文
1 赵慧慧,杜泽清,渠冉,等.卵巢癌免疫治疗的研究进展[J].河北医药,2019,41(2):273-277.
2 Huang YQ ,Guo SH ,Liu R ,et al.Additive analgesic effect of dexmedetomidine and dezocine administered intrathecally in a mouse pain model[J].Oncotarget,2018,9(36):31-35.
3 孙红艳,王改华.不同手术方式治疗卵巢癌临床效果及对患者生育功能的影响[J].陕西医学杂志,2019,48(2):213-216.
4 李洋.腹腔镜手术治疗早期卵巢癌疗效观察[J].新乡医学院学报,2019,36(2):159-161.
5 蔡明林,李晓龙.右美托咪定对全麻下卵巢癌分期手术患者免疫功能的影响[J].解放军医药杂志,2018,30(11):98-101.
6 Wenjuan C,Qin L,Shan X,et al.LC-MS/MS method for simultaneous quantification of dexmedetomidine,dezocine,and midazolam in rat plasma and its application to their pharmacokinetic study[J].Journal of Analytical Methods in Chemistry,2018,17(1):1-7.
7 李巍,崔恒,冯捷,等.卵巢癌诊断的研究进展[J].中华妇产科杂志,2005,40(7):68-70.
8 李冬冬,王莉,钟洁,等.卵巢癌动物模型制备的研究进展[J].中国实验动物学报,2018,26(2):259-264.
9 Kaur N,Goneppanavar U,Venkateswaran R,et al.Comparative effects of buprenorphine and dexmedetomidine as adjuvants to bupivacaine spinal anaesthesia in elderly male patients undergoing transurethral resection of prostrate:A randomized prospective study[J].Anesth Essays Res,2017,11(4):886-891.
10 邓志刚,赵平武,王东.腹腔镜手术与氧化应激[J].腹腔镜外科杂志,2012,17(9):712-714.
11 连红梅,姜丽华.右美托咪定对卵巢癌细胞相关生物学行为的影响[J].实用药物与临床,2018,21(4):369-373.
12 Paunovic V ,Protrka Z ,Ardalic D ,et al.Usefulness of human epididymis protein 4 in predicting optimal cytoreductive therapy in patients with advanced ovarian cancer.[J].Journal of Buon,2017,22(1):29-33.
13 李娜,尹晶晶,刘懿,等.IL-6联合CA125、HE4在早期卵巢癌患者诊断中的临床价值[J].国际检验医学杂志,2019,40(3):285-289.
14 Ren Y ,Xie J ,Lin F ,et al.Serum human epididymis protein 4 is a predictor for developing nephritis in patients with systemic lupus erythematosus:A prospective cohort study[J].International Immunopharmacology,2018,60(2):189-193.
15 齐发梅,魏莲花,周爱花,等.探讨TSGF在6种恶性肿瘤诊断中临床应用价值[J].国际检验医学杂志,2018,39(2):198-199.
16 Chattopadhyay I,Banerjee SS,Jha AK,et al.Effects of intrathecal dexmedetomidine as an additive to low-dose bupivacaine in patients undergoing transurethral resection of prostate[J].Indian Journal of Anaesthesia,2017,61(12):1002-1008.
17 鲁佳,陈亦蛟.右美托咪定对老年结直肠癌根治术患者认知功能及S100β水平的临床研究[J].浙江创伤外科,2018,23(2):413-415.
18 张慧芬,张琨,吴书莹,等.氧化应激与卵巢癌发病机制相关性的研究进展[J].现代肿瘤医学,2017,25(18):3004-3008.
19 赵俊,张曼,刘成赟,等.右美托咪定对老年腹腔镜卵巢癌根治术患者术后苏醒与认知功能的影响研究[J].癌症进展,2018,16(5):626-628,657.
20 Chen Y ,Chen Q ,Liu Q ,et al.Human epididymis protein 4 expression positively correlated with miR-21 and served as a prognostic indicator in ovarian cancer[J].Tumor Biology,2016,37(6):8359-8365.
2 Huang YQ ,Guo SH ,Liu R ,et al.Additive analgesic effect of dexmedetomidine and dezocine administered intrathecally in a mouse pain model[J].Oncotarget,2018,9(36):31-35.
3 孙红艳,王改华.不同手术方式治疗卵巢癌临床效果及对患者生育功能的影响[J].陕西医学杂志,2019,48(2):213-216.
4 李洋.腹腔镜手术治疗早期卵巢癌疗效观察[J].新乡医学院学报,2019,36(2):159-161.
5 蔡明林,李晓龙.右美托咪定对全麻下卵巢癌分期手术患者免疫功能的影响[J].解放军医药杂志,2018,30(11):98-101.
6 Wenjuan C,Qin L,Shan X,et al.LC-MS/MS method for simultaneous quantification of dexmedetomidine,dezocine,and midazolam in rat plasma and its application to their pharmacokinetic study[J].Journal of Analytical Methods in Chemistry,2018,17(1):1-7.
7 李巍,崔恒,冯捷,等.卵巢癌诊断的研究进展[J].中华妇产科杂志,2005,40(7):68-70.
8 李冬冬,王莉,钟洁,等.卵巢癌动物模型制备的研究进展[J].中国实验动物学报,2018,26(2):259-264.
9 Kaur N,Goneppanavar U,Venkateswaran R,et al.Comparative effects of buprenorphine and dexmedetomidine as adjuvants to bupivacaine spinal anaesthesia in elderly male patients undergoing transurethral resection of prostrate:A randomized prospective study[J].Anesth Essays Res,2017,11(4):886-891.
10 邓志刚,赵平武,王东.腹腔镜手术与氧化应激[J].腹腔镜外科杂志,2012,17(9):712-714.
11 连红梅,姜丽华.右美托咪定对卵巢癌细胞相关生物学行为的影响[J].实用药物与临床,2018,21(4):369-373.
12 Paunovic V ,Protrka Z ,Ardalic D ,et al.Usefulness of human epididymis protein 4 in predicting optimal cytoreductive therapy in patients with advanced ovarian cancer.[J].Journal of Buon,2017,22(1):29-33.
13 李娜,尹晶晶,刘懿,等.IL-6联合CA125、HE4在早期卵巢癌患者诊断中的临床价值[J].国际检验医学杂志,2019,40(3):285-289.
14 Ren Y ,Xie J ,Lin F ,et al.Serum human epididymis protein 4 is a predictor for developing nephritis in patients with systemic lupus erythematosus:A prospective cohort study[J].International Immunopharmacology,2018,60(2):189-193.
15 齐发梅,魏莲花,周爱花,等.探讨TSGF在6种恶性肿瘤诊断中临床应用价值[J].国际检验医学杂志,2018,39(2):198-199.
16 Chattopadhyay I,Banerjee SS,Jha AK,et al.Effects of intrathecal dexmedetomidine as an additive to low-dose bupivacaine in patients undergoing transurethral resection of prostate[J].Indian Journal of Anaesthesia,2017,61(12):1002-1008.
17 鲁佳,陈亦蛟.右美托咪定对老年结直肠癌根治术患者认知功能及S100β水平的临床研究[J].浙江创伤外科,2018,23(2):413-415.
18 张慧芬,张琨,吴书莹,等.氧化应激与卵巢癌发病机制相关性的研究进展[J].现代肿瘤医学,2017,25(18):3004-3008.
19 赵俊,张曼,刘成赟,等.右美托咪定对老年腹腔镜卵巢癌根治术患者术后苏醒与认知功能的影响研究[J].癌症进展,2018,16(5):626-628,657.
20 Chen Y ,Chen Q ,Liu Q ,et al.Human epididymis protein 4 expression positively correlated with miR-21 and served as a prognostic indicator in ovarian cancer[J].Tumor Biology,2016,37(6):8359-8365.