不同麻醉方式对老年结肠癌患者围术期外周血炎性因子和T淋巴细胞亚群的影响

不同麻醉方式对老年结肠癌患者围术期外周血炎性因子和T淋巴细胞亚群的影响

杨华,嵇君伟,邵芸,刘雯,程华春,周建文,陆惠勤

上海市市东医院麻醉科邮编：,上海市市东医院麻醉科邮编：,上海市市东医院麻醉科邮编：,上海市市东医院麻醉科邮编：,上海市市东医院麻醉科邮编：,上海市市东医院检验科邮编：,上海市市东医院检验科邮编：

收稿日期:2018-11-11 修回日期:2018-11-15 出版日期:2018-12-25

Effects of Different Anesthesia on Peripheral Blood Inflammatory Cytokines and T-lymphocyte Subsets in Elderly Patients with Colon Cancer During Perioperative Period

YANG Hua,JI Junwei,SHAO Yun,LIU Wen,CHENG Huachun,ZHOU Jianwen and LU Huiqin

Department of Anesthesiology,Shanghai East Hospital,Zip Code:,Department of Anesthesiology,Shanghai East Hospital,Zip Code:,Department of Anesthesiology,Shanghai East Hospital,Zip Code:,Department of Anesthesiology,Shanghai East Hospital,Zip Code:,Department of Anesthesiology,Shanghai East Hospital,Zip Code:,Department of Clinical Laboratory,Shanghai East Hospital,Zip Code:,Department of Clinical Laboratory,Shanghai East Hospital,Zip Code:

Received:2018-11-11 Revised:2018-11-15 Online:2018-12-25

摘要/Abstract

摘要： 目的：探讨不同麻醉方式对老年结肠癌患者围术期外周血炎性因子和T淋巴细胞亚群的影响。方法：将84例接受根治性切除术的老年结肠癌患者随机分成两组，分别采用全身麻醉（对照组，n=42）、全身麻醉复合硬膜外阻滞(复合组，n=42)。比较两组患者围术期相关指标、外周血T淋巴细胞亚群（CD3+、CD4+、CD8+）、白介素6(IL-6)、肿瘤坏死因子-α(TNF-α)水平。结果：复合组患者术中丙泊酚用量少于对照组（P<0.05）；T1时刻，复合组TNF-α、IL-6水平较T0时刻升高，但IL-6低于对照组同期水平（P<0.05）；T2时刻，复合组TNFα基本恢复至T0时刻水平，对照组IL-6水平较T0时刻升高，复合组IL-6低于对照组水平（P<0.05）。T1时刻，两组CD3+、CD4+、CD8+、CD4+/CD8+均较T0时刻降低(P<0.05)；T2时刻，复合组T淋巴细胞亚群各指标与T0时刻比较差异均无统计学意义(P>0.05)，均高于对照组(P<0.05)。结论：全身麻醉复合硬膜外阻滞用于老年结肠癌患者，既可减少麻醉药物用量，又可抑制应激反应及炎性细胞因子表达，促进围术期免疫功能的恢复。

Abstract: Objective：To explore the effect of different anesthesia on peripheral blood inflammatory cytokines and Tlymphocyte subsets in elderly patients with colon cancer during perioperative period. Methods： 84 elderly patients with colon cancer who received radical operation were randomly and equally divided into the control group (n=42) and the compound group (n=42). The control group and the compound group were given general anesthesia and general anesthesia combined with epidural block， respectively. The perioperative related indicators， levels of peripheral blood T-lymphocyte subsets (CD3+， CD4+， CD8+)， interleukin 6 (IL-6)， tumor necrosis factor alpha (TNF-α) in both groups were compared. Results：The dosage of propofol used in the compound group was lower than that in the control group (P<0.05). At T1 moment， the levels of TNF-α， IL-6 in the compound group were increased than T0 moment， but level of IL-6 in the compound group was lower than those in the control group (P<0.05). At T2 moment， the level of TNF-α in the compound group return to T0 time， the level of IL-6 in the control group was higher than that at T0 moment， and IL-6 in the compound group was lower than that in the control group (P<0.05). At T1 moment， the levels of CD3+， CD4+， CD8+， CD4+/CD8+ in both groups were decreased than T0 moment (P<0.05). At T2 moment， there was no significant difference on T-lymphocyte subsets in the compound group compared with T0 moment (P>0.05)， but were higher than those in the control group (P<0.05). Conclusion： General anesthesia combined with epidural block for elderly patients with colon cancer can reduce the dosage of anesthetic drugs， restrain stress reaction and inflammatory cytokines， and enhance the recovery of perioperative immune function.

杨华,嵇君伟,邵芸,刘雯,程华春,周建文,陆惠勤. 不同麻醉方式对老年结肠癌患者围术期外周血炎性因子和T淋巴细胞亚群的影响[J]. .

YANG Hua,JI Junwei,SHAO Yun,LIU Wen,CHENG Huachun,ZHOU Jianwen and LU Huiqin. Effects of Different Anesthesia on Peripheral Blood Inflammatory Cytokines and T-lymphocyte Subsets in Elderly Patients with Colon Cancer During Perioperative Period[J]. .

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