乌司他丁对肝癌患者高强度聚焦超声治疗期炎性因子的影响  

Effect of ulinastatin on cytokines during high intensity focused ultrasound treatment in patients with liver cancer

作　　者：陈岗[1] 唐胜平[2] 米卫东[1] 张宏[1] 

机构地区：[1]解放军总医院麻醉科,北京市100853 [2]解放军307医院麻醉科

出　　处：《临床麻醉学杂志》2007年第7期595-596,共2页Journal of Clinical Anesthesiology

摘　　要：目的了解肝癌患者进行高强度聚焦超声(HIFU)治疗期C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)和肿瘤坏死因子α(TNF-α)的变化以及乌司他丁对它们的影响。方法20例肝动脉插管化疗栓塞后择期行HIFU治疗肝癌患者,随机分为对照组(C组)和乌司他丁组(U组),每组10例。U组于麻醉诱导后缓慢静注乌司他丁20万U,C组用等量生理盐水代替。分别于HIFU治疗前(T1)、治疗结束时(T2)和治疗结束后24h(T3)采取外周静脉血样测血浆CRP、IL-6、IL-8、IL-10和TNF-а浓度。结果C组在T2、T3时CRP和TNF-а的浓度较T1时有明显升高(P<0.05或P<0.01)。U组CRP的浓度在T2、T3时较T1时有明显升高(P<0.05),但T3时的浓度明显低于C组(P<0.05);IL-10在T2、T3时明显升高(P<0.05或P<0.01),且T2时高于C组(P<0.05);而IL-6、IL-8和TNF-а的浓度在T2、T3时与T1时相比均无明显改变。结论HIFU治疗肝癌时引起炎性因子的升高,乌司他丁可下调HIFU治疗期间产生的促炎因子并可上调产生的抗炎因子。Objective To investigate the effects of ulinastatin on cytokines in patients with liver cancer during the treatment of high intensity focused ultrasound （HIFU）. Methods Twenty ASA class Ⅱ or Ⅲ liver cancer patients,scheduled for the treatment of HIFU,were randomly divided into two groups with 10 cases each. The patients in group U received intravenous infusion of ulinastatin after anesthesia induction and the same amount of normal saline was given instead of ulinastatin in group C, Plasma concentrations of CRP and TNF-a were measured before the treatment （T1） ,at the end of the treatment （T2） and 24 h after the treatment （T3）. Results In group C, plasma concentrations of CRP, IL-6, IL-8, IL-10 and TNF-α were significantly increased at T2 and T3 compared with those at T1 （P〈0. 05 or P〈0. 01）, In group U,although plasma concentration of CRP was also increased at T2 and T3 compared with those at T1 （P〈0.05）, the increase of CRP was significantly lower than that in group C at T3 （P〈0. 05）, Plasma concentration of IL-10 in group U was increased at T2 and T3 compared with that at T1 （P〈0. 05 or P〈0.01） and was significantly higher than that in group C at T2 （P〈0. 05）. Plasma concentrations of IL-6, IL-8 and TNF-α at T1 were not significantly different from those at T2 and T3 in group U. Conclusion The treatment of HIFU increased cytokine production of patients. Ulinastatin can decrease proinflammatory factor and increase antiinflammatory factor during the treatment of HIFU in the patients with liver cancer.

关 键 词：乌司他丁 超声疗法 肝癌 细胞因子 

分 类 号：R614[医药卫生—麻醉学]