两种麻醉方式对荷瘤大鼠肿瘤转移的影响  

Effects of neuraxial block and general anesthesia on tumor metastasis in rats

作　　者：郑伟[1] 李艳萍[2] 赖仁纯[1] 卢雅立[1] 沈智文[2] 王旭东[1] 

机构地区：[1]中山大学肿瘤防治中心麻醉科,广东广州510060 [2]中山大学附属第二医院麻醉科,广东广州510120

出　　处：《南方医科大学学报》2008年第12期2218-2220,共3页Journal of Southern Medical University

基　　金：广东省科技计划项目(2005B30301001);广东省医学科研项目(A2005249)

摘　　要：目的探讨不同麻醉方法对荷瘤大鼠免疫监视功能及肿瘤肺转移的影响。方法Fischer344大鼠72只随机分为3组:氯氨酮全麻组(K组);丙泊酚全麻组(P组);椎管内阻滞组(B组),每组24只。各组大鼠行剖腹探查术。术后经大鼠尾静脉注入MADB106肿瘤细胞。24h检测淋巴细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+、NK细胞(CD161a+)数量及NK细胞活性。3周后测肺转移瘤的数量。结果与B组比较,K组和P组大鼠CD3+、CD4+、CD4+/CD8+、CD161a+数量及NK细胞活性明显下降,而肺转移瘤明显增多(P<0.05或P<0.01);除CD8+外,K组在其他免疫监视功能指标均低于P组,肿瘤转移瘤明显增多(P<0.05或P<0.01)。结论椎管内阻滞麻醉比全麻更能有效保护免疫监视功能,在减少荷瘤大鼠肿瘤转移方面优于全麻。Objective To investigate the effects of different anesthesia methods on immune surveillance and tumor metastasis in tumor-bearing rats. Methods Seventy-two Fischer 344 rats were randomly assigned into 3 equal groups and anesthetized for 1 h with ketamine （group K）, propofol （group P）, or neuraxial block （group B）. All the rats were subjected to laparotomy followed by intravenous injection of MADB 106 tumor cells, and 24 h after the injection, the number and activity of circulating CD3^＋、 CD4^＋、 CD8^＋、and D4^＋/CD8^＋ lymphocyte subsets and NK cell （CD161a^＋）were assessed. Three weeks later, the lung metastases were counted. Results Compared with those in group B, the numbers of CD3^＋、 CD4^＋、 CD8^＋、 and CD161a^＋ lymphocytes and the activity of circulating NK cells were significantly reduced, and the lung metastases of MADB106 increased significantly in groups K and P （P〈0.05 or 0.01 ）. The activity of immune surveillance in group K was significantly lower than that in group P except for CD8^＋ cells, and the tumor metastases in group K increased significantly in comparison with those in group P （P〈0.05 or 0.01）. Conclusion Neuraxial block provides protection of the activity of immune surveillance and reduces tumor metastases in tumor-beating rats compared with general anesthesia.

关 键 词：全麻 椎管内阻滞 免疫监视 肿瘤转移 

分 类 号：R614.24[医药卫生—麻醉学]