术前静注氯诺昔康对子宫切除术患者免疫功能的影响  

Effects of preoperative intravenous lornoxicam on immune function of patients undergoing total abdominal hysterectomy

作　　者：宋根华[1] 陈华莲[1] 

机构地区：[1]湖南省怀化市中医院,湖南怀化418000

出　　处：《安徽医药》2010年第5期583-585,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨术前静注氯诺昔康对子宫切除术患者围手术期血浆调节活化正常T细胞表达和分泌因子(RANTES)、基质细胞衍生因子-1α(SDF-1α)和单核细胞趋化蛋白-1(MCP-1)表达水平的影响。方法选取择期行子宫切除术患者45例,随机分为三组:生理盐水对照组(术前静注生理盐水4 m l)、氯诺昔康8 mg组(术前静注氯诺昔康8 mg)和氯诺昔康16 mg组(术前静注氯诺昔康16 mg)。先后在开放静脉前(T0)、手术切皮后30 m in(T1)、手术结束时(T2)、术后24 h(T3)和术后48 h(T4)采集各组患者的静脉血,运用酶联免疫吸附试验(ELASA)测定血浆RANTES、SDF-1α和MCP-1的表达水平。结果与生理盐水对照组相比,术前静注氯诺昔康,可增加血浆中RANTES的表达水平,降低MCP-1和SDF-1α的表达水平。结论手术与麻醉引起的创伤可导致子宫切除术患者围手术期血浆趋化因子表达水平的改变,术前静注氯诺昔康可有效逆转这一变化,从而有助于维持患者细胞免疫功能的稳定。Aim To assess the perioperative effects of preoperative intravenous lornoxicam on the serum levels of regulated upon activation normal T cell expressed and secreted（RANTES）,monocyte chemotactic protein-1（MCP-1）,and stromal cell-derived factor 1 alpha（SDF-1α） in patients undergoing total abdominal hysterectomy（TAH）.Methods 45 patients undergoing TAH were randomly divided into 3 groups：group NS,group L8 and group L16 who were given intravenous injection of 4ml normal sodium as control,LOR 8mg,and LOR 16mg,respectively,before the induction of anesthesia in a double-blinded fashion.Venous blood samples were taken before anesthesia（T0）,at 30 min after operation（T1）,at the end of operation（T2）,24 h and 48 h after operation（T3 and T4,respectively） to determine the serum levels of RANTES,MCP-1,and SDF-1α by enzyme-linked immunosorbent assay（ELISA）.Results Compared with Group NS,the serum RANTES levels in group L8 and group L16 were significantly lower,and the expression of MCP-1 and SDF-1α in group L8 and group L16 were both increased.Conclusion To sum up,our data suggest that preoperative intravenous LOR may increase the serum RANTES level,and decrease MCP-1 and SDF-1α expression in order to effectively relieve the perioperative immuno-suppression caused by TAH.

关 键 词：氯诺昔康 子宫切除术 调节活化正常T细胞表达和分泌因子 基质细胞衍生因子-1Α 单核细胞趋化蛋白-1 

分 类 号：R614[医药卫生—麻醉学]