雷米芬太尼对腹腔镜胆囊切除术患者IL-6、IL-8和IL-10的影响  

Effect of remifentanil on serum IL-6,IL-8,and IL-10 in patients undergoing laparoscope cholecystectomy

作　　者：尹罗庚 袁玉萍[2] 周红云[2] 庄建伟[3] 吴文玉[1] 丁德威 

机构地区：[1]江苏省镇江市第二人民医院麻醉科,212002 [2]江苏省镇江市第二人民医院普外科,212002 [3]江苏省镇江市第二人民医院检验科,212002

出　　处：《临床麻醉学杂志》2006年第8期605-607,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察全麻下雷米芬太尼与芬太尼对腹腔镜胆囊切除术（LC）患者白细胞介素（IL）-6、IL-8和IL-10的影响。方法20例LC患者，随机分为两组，每组10例。雷米芬太尼组（Ⅰ组）和芬太尼组（Ⅱ组），分别测定麻醉诱导前、气腹手术前、气腹手术后0．5h、术毕0．5h、术后24h的血清IL-6、IL-8和IL-10的水平。结果IL-6、IL-8和IL-10在创伤后1～1．5h开始升高，IL-6的变化最早，IL-8、IL-10在手术结束时逐渐升高，IL-6、IL-8在术后24h仍在继续上升（P〈0.05），而IL-10则有不升或缓升趋势。IL-10对IL-6和IL-8的升高有一定的平衡作用。组间比较，术后24h Ⅰ组IL-6、IL-8较Ⅱ组都有明显升高（P〈0．01）。结论与芬太尼相比，雷米芬太尼可更为有效地减轻创伤刺激后IL-6、IL-8和IL-10的释放。Objective To evaluate the influence of remifentanil on serum interleukin（IL）-6, IL-8,and IL-10 levels in the patients of laparoscope cholecystectomy（LC）. Methods Twenty ASA class Ⅰ or Ⅱ patients undergoing LC were randomized to receive either remifentanil（group [ ,n= 10） or fentanyl in general anesthesia（group Ⅱ , n=10）. Peripheral venous blood samples were taken before induction,before skin incision,at 0.5 h after skin incision,0.5 h and 24 h after surgery for determination of IL-6,IL-8 and IL-10 levels. Results IL-6,IL-8 and IL-10 levels began to increase 1-1.5 h after skin incision. IL-6 level changed earlist,and IL-8, IL-10 levels elevated gradually at the end of surgery. IL-6 and IL-8 levels were continuing to rise 24 h after operation（P〈0.05）. IL-10 level remained unchanged or tended to increase slowly. IL-10 seemed to have some inhibiting effect on the increase of IL-6,IL-8 and IL-8 levels of group Ⅱ were obviously higher than that of group Ⅰ at 24 h after operation（P〈0.01）. Conclusion Remifentanil can reduce the expression of IL-6, IL-8 and IL-10 in the patients unduging LC under general anesthesia.

关 键 词：雷米芬太尼 芬太尼 腹腔镜胆囊切除术 白细胞介素-6 白细胞介素-8 白细胞介素-10 

分 类 号：R614[医药卫生—麻醉学]