右美托咪定对原发性肝癌患者围术期免疫功能的影响
摘要
目的探讨右美托咪定对原发性肝癌患者围术期免疫功能的影响。方法选择我院肝胆外科手术治疗的60例原发性肝癌患者,采用随机数字表法,将患者分为右美托咪定组(D组)和对照组(C组),每组30例。D组在麻醉诱导前15min采用微量泵静脉泵注盐酸右美托咪定注射液,负荷剂量为1.0μg/kg,15min泵完,随后而以0.5μg·kg~(-1)·h~(-1)的速率维持至手术结束,C组患者按照D组的方法给予等容量的生理盐水。分别在患者麻醉诱导前(T_0)、手术开始后2h、手术结束后6h、1d、3d以及7d(T_1-T_5)时采集所有患者的静脉血样,检测患者的T淋巴细胞亚群以及NK细胞的浓度,并计算CD4~+/CD8~+比值;采用Elisa法测定血清IL-6及IL-10水平。结果与C组比较,D组T_1-T_3时CD3~+、CD4~+、NK细胞浓度及CD4~+/CD8~+比值明显升高,血清IL-6水平降低,IL-10水平升高(P<0.05),CD8~+水平各时点差异无统计学意义(P>0.05)。结论右美托咪定可减轻肝癌患者围术期T淋巴亚群及NK细胞下降的程度,并能在一定程度上改善患者术后免疫功能。
引文
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[13]Wang L,Zhang A,Liu W,et al.Effects of dexmedetomidine on perioperative stress response,inflammation and immune function in patients with different degrees of liver cirrhosis[J].Exp Ther Med,2018,16(5):3869-3874.
[2]Cata JP,Bauer M,Kurz A,et al.Effects of surgery,general anesthesia,and perioperative epidural analgesia on the immune function of patients with non-small cell lung cancer[J].J Clin Anesth,2013,S0952-8180(13):125-126.
[3]田俊英,张红艳,郭光华.右美托咪定在烧伤后多器官功能障碍综合征中的器官保护作用[J].江西医药,2018,53(10):1177-1180.
[4]徐兴国,陈红生,崔松勤,等.右美托咪定对胃癌根治术患者围手术期白细胞介素-6、皮质醇及T淋巴细胞亚群的影响[J].临床麻醉学杂志,2012,28(5):480-482.
[5]袁静,卢航青,郑康,等.右美托咪定对食管癌患者围术期免疫功能的影响[J].中国老年学杂志,2013,33(1):59-61.
[6]潘新有,赵凤.原发性肝癌证型分布规律及相关客观指标分析[J].江西医药,2016,51(4):376-378.
[7]陈淼,周凯.肝癌合并门静脉高压症的治疗研究进展[J].江西医药,2014,49(8):775-778.
[8]高立生,刘宁宁,邵雪斋,等.肿瘤对机体免疫功能影响的研究进展[J].河北医学,2013,14(9):1001-1004.
[9]Latorre J,Moreno-Navarrete JM,Sabater M,et al.Decreased TLR3in Hyperplastic Adipose Tissue,Blood and Inflamed Adipocytes is Related to Metabolic Inflammation[J].Cell Physiol Biochem,2018,51(3):1051-1068.
[10]Wang L,Zhang A,Liu W,et al.Effects of dexmedetomidine on perioperative stress response,inflammation and immune function in patients with different degrees of liver cirrhosis[J].Exp Ther Med,2018,16(5):3869-3874.
[11]Weerink MAS,Struys MMRF,Hannivoort LN,et al.Clinical Pharmacokinetics and Pharmacodynamics of Dexmedetomidine[J].Clin Pharmacokinet,2017,56(8):893-913.
[12]Mukherjee A,Das A,Mayur N,et al.Comparative evaluation of analgesic sparing efficacy between dexmedetomidine and clonidine used as adjuvant to ropivacaine in thoracic paravertebral block for patients undergoing breast cancer surgery:A prospective,randomized,double-blind study[J].Saudi J Anaesth,2018,12(4):548-554.
[13]Wang L,Zhang A,Liu W,et al.Effects of dexmedetomidine on perioperative stress response,inflammation and immune function in patients with different degrees of liver cirrhosis[J].Exp Ther Med,2018,16(5):3869-3874.