摘要
目的探讨不同剂量右美托咪定在麻醉期间对Th1和Th2细胞因子及免疫功能的影响。方法71例行腹腔镜胆囊切除术患者随机分为3组:对照组(A组,n=23)、0.5μg/kg右美托咪定剂量组(B组,n=25)、1.0μg/kg右美托咪定剂量组(C组,n=23)。分别在T0(手术前基线)、T1(腹膜闭合末期)、T2(手术后1 h)和T3(术后24 h)测定血清中的IL-4、IFN-γ和IL-12含量和外周血CD3^+、CD4^+和CD8^+T细胞。结果Th1/Th2型细胞因子比较结果显示,在T1、T2和T3时,3组患者的IFN-γ、IL-12水平和IFN-γ/IL-4比值差异有统计学意义(P<0.05)。在T2和T3时,A组和B组的IFN-γ水平和IFN-γ/IL-4比值均显著低于T0时水平(P<0.05)。3组在T1和T2时的IL-12水平均显著低于T0时水平(P<0.05)。外周血T细胞比较结果显示,在T1和T2时,3组患者的CD3^+、CD4^+T细胞水平和CD4^+/CD8^+比值差异有统计学意义(P<0.05)。组内比较显示,在T1和T2时,3组患者的CD3^+、CD4^+T细胞水平和CD4^+/CD8^+比值均显著低于T0时水平(P<0.05)。结论术中给予右美托咪定可减弱患者在手术和麻醉期间的不良免疫反应。
Objective To evaluate the effects of different doses of dexmedetomidine on Th1/Th2 cytokines and T cell apoptosis in peripheral blood of anaesthetists.Methods A total of 71 patients undergoing laparoscopic cholecystectomy in our hospital from March 2017 to May 2018 were randomly divided into three groups:control group(group A,n=23),0.5μg/kg dexmedetomidine dose group(group B,n=25),1.0μg/kg dexmedetomidine dose group(group C,n=23).The levels of interleukin-4(IL-4),interferon-gamma(IFN-γ)and interleukin-12(IL-12)in serum and CD3^+,CD4^+and CD8^+T cells in peripheral blood were measured at T0(baseline before surgery),T1(at the end of peritoneal closure),T2(1 h after surgery)and T3(24 h after surgery).Results The results of Th1/Th2 cytokine comparison showed that the levels of IFN-gamma,IL-12 and the ratio of IFN-γ/IL-4 at T1,T2 and T3 were significantly different among the three groups,with the differences statistically significant(P<0.05).At T2 and T3,the levels of IFN-γand IFN-γ/IL-4 ratios in group A and B were significantly lower than those at T0(P<0.05).At T1 and T2,the levels of IL-12 in the three groups were significantly lower than those at T0(P<0.05).The results of peripheral blood T cell comparison showed that the levels of CD3^+,CD4^+T cells and the ratio of CD4^+/CD^+8 at T1 and T2 were significantly different among the three groups(P<0.05).At T1 and T2,the levels of CD3^+,CD4^+T cells and the ratio of CD4^+/CD8^+in the three groups were significantly lower than those at T0,with the differences statistically significant(P<0.05).Conclusion Intraoperative dexmedetomidine administration can attenuate the surgical stress-induced adverse immune response in patients during surgical and anesthetic stress.
作者
侯俊青
李勇
胡君为
HOU Jun-qing;LI Yong;HU Jun-wei(Anesthesiology Department,Xiaoshan Hospital of Traditional Chinese Medicine,Hangzhou,Zhejiang 311201,China)
出处
《中国卫生检验杂志》
CAS
2020年第19期2366-2369,共4页
Chinese Journal of Health Laboratory Technology
作者简介
侯俊青(1971-),男,硕士,副主任医师,主要从事临床麻醉方面的工作。
