吗啡和电针对术后淋巴细胞增殖反应和T细胞亚群的影响  

EFFECT OF EPIDURAL MORPHINE AND ELECTROACUPUN CTURE(EA) ON LYMPHOCYTE PROLIFERATION AND T LYMPHOCYTE SUBTYPES OF POSTOPERATIVE PATIENTS

作　　者：章宇[1] 杜莅娜[1] 吴根诚[1] 曹小定[1] 俞莹芳[2,3] 唐辉毅[2,3] 蔡定芳 

机构地区：[1]上海医科大学医学神经生物学国家重点实验室 [2]上海华山医院麻醉科 [3]上海华山医院脏象研究室

出　　处：《中国免疫学杂志》1997年第2期119-123,共5页Chinese Journal of Immunology

基　　金：国家攀登计划项目基金

摘　　要：为了观察硬膜外吗啡和电针对术后病人免疫功能的影响，对１８例单纯胆囊切除术病人分别于术前和术后第１、３、７天检测淋巴细胞增殖反应和Ｔ细胞亚群的变化。结果表明硬膜外注入吗啡１ｍｇ在有效镇痛的同时却抑制了淋巴细胞增殖反应直至术后第７天，并出现Ｔ细胞亚群中ＣＤ３＋、ＣＤ４＋表达下降。由于电针能改善硬膜外吗啡引起的淋巴细胞增殖反应抑制和Ｔ细胞亚群的异常变化，提示电针结合硬膜外吗啡是值得推荐的术后镇痛方法。The influences of morphine and EA on PHA m induced lymphocyte proliferation and T lymphocyte subtypes of postoperative patients were investigated in 18 cholesystectomy cases.All patients were divided into three groups:operation group;morphine group(injected 1 mg morphine into epidural space);Morphine+EA group(EA of Zusanli,Sanyinjiao,Hegu,Neiguan points were used 1 h after epidural injection of morphine and lasted 1 h).The 4th group is control group(normal subjects).Peripheral blood were taken before and in 1,3,7 days after operation.Compared with control group,lymphocyte proliferation of morphine group was not only depressed on 1 st and 3 rd day after surgery as operation group,but also lasted 7 days after surgery,EA can antagonize the immunosuppression produced by morphine.The fluorecently labeled monoclonal antibodies to cell surface antigens of CD3,CD4,CD8 were incubated in blood without red cells and analyzed by FACS.Results showed that the percentage of CD3 +,CD4 + cells were decreaseed in operation group in 1 st day and suppressed in morphine group in 7 th day after surgery,there was no significant changes in morphine+EA group.Epidural morphine combined with EA might be a better method to relieve clinical postoperative pain.

关 键 词：吗啡 电针 手术后 淋巴细胞增殖 T细胞亚群 

分 类 号：R619.9[医药卫生—外科学]