氯胺酮和异丙酚麻醉对胃癌手术患者围术期血浆细胞因子的影响  

Effects of ketamine and propofol on levels of perioperative plasma cytokines in gastric cancer patients underwent radical gastrectomy

作　　者：辛敏钢[1] 叶虹[1] 张耀中[1] 巴凤海[1] 

机构地区：[1]吉林大学中日联谊医院麻醉科,吉林长春130033

出　　处：《吉林大学学报（医学版）》2007年第6期1070-1072,共3页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅基金资助课题(20030538)

摘　　要：目的：研究氯胺酮和异丙酚麻醉对胃癌手术患者围术期血浆细胞因子的影响。方法：选择ASAⅠ～Ⅱ级择期行胃癌根治术患者40例，随机分为氯胺酮组（Kt组，n=20）和异丙酚组（Pf组，n=20），于麻醉诱导前、切皮后1h、手术结束时和术后24h分别采取外周静脉血，用酶联免疫吸附法（ELISA）检测血浆TNF-α含量和IL-6和IL-8、IL-10水平。结果：Kt组患者切皮后1h、手术结束时和术后24h血浆TNF-a、IL-6和IL-8较麻醉诱导前均增高，但差异无显著性（P〉0．05），Pf组切皮后1h和手术结束时血浆TNF-α、IL-6和IL-8均高于麻醉诱导前（P＜0．05或P＜0．01），与Kt组相应时点比较差异也有显著性（P＜0．05或P＜0．01）；Kt组患者切皮后1h、手术结束时和术后24h血浆IL-10较麻醉诱导前增高，但差异无显著性（P〉0．05），而Pf组则显著增高，与麻醉诱导前和Kt组相应时点比较差异有显著性（P〈0．05）。结论：氯胺酮和异丙酚麻醉能促进胃癌手术患者产生致炎性和抗炎性细胞因子，并能保持两者的平衡。氯胺酮较异丙酚有明显的抑炎作用。Objective To study the effect of ketamine and propofol on levels of perioperative plasma cytokines in gastric cancer patients underwent radical gastrectomy. Methods Forty ASA Ⅰ-Ⅱ patients with gastric cancer were randomly divided into ketamin group （Kt group, n = 20） and propofol （Pf group, n = 20）, peripheral vennes blood samples were taken before anesthesia, 1 h after skin incision, at the end of surgery and 24 h after operation. The plasma TNF-α, IL-6, IL-8 and IL-10 levels were determined respectively with ELISA methods. Results The levels of plasma TNF-a, IL-6 and IL-8 at 1 h after incision, at the end of surgery, and 24 h after operation in Kt group were increased, but there were no significant differences compared with before anesthesia （P〉0.05）. In Pf group, the levels of plasma TNF-α, IL-6 and IL-8 at 1 h after skin incision and the end of surgery were higher than those before anesthesia and those in Kt group （P〈0.05 or P〈0.01）. In Kt group, the level of plasma IL-10 was increased, but there was no significant difference compared with before anesthesia （P〉0. 05）. The plasma IL-10 level in Pf group was increased obviously compared with before anesthesia （P〈0.05）. Conclusion Ketamine and propofol anesthesia can lead to take proinflammatory and antinflammatory cytokines in gastric cancer patients underwent radical gastrectomy, and keep balance between of them. Ketamine had more obviously antiflammatory effect than propofol.

关 键 词：氯胺酮 异丙酚 胃肿瘤/外科学 细胞因子类 

分 类 号：R614.24[医药卫生—麻醉学] R735.2[医药卫生—外科学]