术前静脉注射氯诺昔康对子宫切除术患者围术期血浆RANTES浓度的影响  

Effect of preoperative intravenous lornoxicam on plasma concentration of T-cell expressed and secreted regulatory activating factor during perioperative period

作　　者：唐琦峰[1] 邱玉华[2] 王忠云[3] 张洪兴[1] 钱燕宁[3] 

机构地区：[1]南京医科大学附属苏州医院麻醉科,215008 [2]苏州大学免疫学教研室 [3]南京医科大学第一附属医院麻醉科

出　　处：《中华麻醉学杂志》2007年第9期789-791,共3页Chinese Journal of Anesthesiology

基　　金：江苏省医学重点人才资助项目（RC2002058）;苏州市科教兴卫青年专项基金资助项目（SWQ21）

摘　　要：目的探讨术前静脉注射氯诺昔康对子宫切除术患者围术期血浆T细胞表达和分泌的调节性激活因子（RANTES）浓度的影响。方法择期行子宫切除术患者30例,随机分为3组（n=10）,对照组（C组）,氯诺昔康8 mg组（L8组）麻醉前单次静脉注射氯诺昔康8 mg,氯诺昔康16 mg组（L16组）麻醉前单次静脉注射氯诺昔康16 mg。分别在开放静脉前（T0）、切皮后30 min（T1）、术毕（T2）、术后24 h（T3）和术后48 h（T4）采集外周静脉血,测定血浆RANTES的浓度。结果与T0时比较,C组、L8组、L16组在T1～T3时血浆RANTES浓度降低（P〈0.05）;与C组比较,L8组、L16组血浆RANTES浓度升高（P〈0.05）;与L8组比较,L16组血浆RANTES浓度升高（P〈0.05）,呈剂量依赖性。结论术前静脉注射氯诺昔康16 mg可抑制子宫切除术患者围术期血浆RANTES浓度的下降,提示可能有助于维持细胞免疫功能的稳定。Objective To investigate the effect of intravenous lornoxicam given before operation on plasma concentration of T cell expressed and secreted regulatory activating factor （RANTES） during perioperative period. Methods Thirty ASA Ⅰ or Ⅱ patients aged 33-59 yr weighing 44-73 kg undergoing elective hysterectomy were randomly divided into 3 groups （ n = 10 each） ： group Ⅰ control; group Ⅱ received lornoxicam 8 mg iv before operation （L8 ） and group Ⅲ received lornoxicam 16 mg iv before operation （L16） . The patients were premedicated with intramuscular sodium phenobarbital 0.1 g atopine 0.5 mg. Continuous epidural anesthesia was performed at L2,3 interspace. Correct epidural catheter placement was confirmed by giving a test dose of 2% lidocaine 5 ml. Then a mixture of 0.25 % tetracaine and 1% lidocaine 12-15 ml was injected for epidural block. The sensory block extended from T6 to L3 . All of the patients received epidural analgesia with a mixture of ropivacaine 150 mg and morphine 4 mg in 100 ml normal saline （loading dose 5 ml, background infusion 2 ml/h） after operation for 50 h. Blood samples were taken before anesthesia （ To , baseline）, at 30 min after skin incision （ T1 ）, at the end of operation （T2） and 24 h and 48 h after operation （ T3 , T4 ） for determination of plasma RANTES concentration. Results The plasma RANTES concentrations were significantly decreased at T1,3 as compared to the baseline values at To in all 3 groups and were significantly higher in the 2 lornoxicam groups than in control groups dosedependently. Conclusion Lornoxicam 16 mg given iv before hysterectomy can significantly inhibit the decrease in plasma RANTES concentration induced by operation and help maintain the stability Of cellular immune function of the patients.

关 键 词：消炎药 非甾类 炎症趋化因子类 子宫切除术 手术期间 

分 类 号：R686[医药卫生—骨科学]