不同剂量氯诺昔康对子宫切除术患者免疫功能的影响  

Effect of intravenous lornoxicam at different doses on the immune function in patients undergoing total abdominal hysterectomy

作　　者：焦赫娜[1] 任飞[1] 蔡宏伟[1] 

机构地区：[1]中南大学湘雅医院麻醉科,湖南长沙410008

出　　处：《南方医科大学学报》2010年第8期1844-1846,共3页Journal of Southern Medical University

基　　金：湖南省科技厅科研基金(湘财教指2009-42)

摘　　要：目的探讨不同剂量氯诺昔康对子宫切除术患者免疫功能的影响。方法 45例在全身麻醉下行经腹子宫切除术病人随机分为3组,分别在麻醉诱导前30min静脉推注生理盐水4ml（NS组）、氯诺昔康8mg（L8组）、氯诺昔康16mg（L16组）。于注射氯诺昔康前1min（T0）,手术开始后30min（T1）,手术结束时（T2）,术后24h（T3）和术后48h（T4）采静脉血用酶标记免疫吸附测定法测定趋化因子RANTES、单核细胞趋化蛋白-1（MCP-1）和基质细胞衍生因子1α（SDF-1α）。结果在NS组和L8组血清RANTES浓度在T1T3时间点均显著低于T0（P〈0.05）,L8组在T3、T4时间点血清RANTES水平均高于NS组（P〈0.05）。此外,L16组血清RANTES浓度与T0比仅在T2时间点下降,组间比较在T1T3显著高于NS组和L8组（P〈0.05）,在T4时间点显著高于NS组。3组MCP-1和SDF-1α的表达分别在T1和手术后达到峰值。L8组和L16组,MCP-1在T2T3和SDF-1α在T1T2的表达均显着低于NS组（P〈0.05）。L16组SDF-1α在T1T2表达显著低于L8组（P〈0.05）。此外,MCP-1和SDF-1α在L16组的下降趋势比L8组明显。结论手术前静脉注射氯诺昔康可增加血清RANTES水平,降低MCP-1和SDF-1α的表达,静脉注射氯诺昔康16mg效果优于注射8mg。Objective To investigate the effect of intravenous lornoxicam （LOR） at different doses given preoperatively on the immune function of patients undergoing total abdominal hysterectomy （TAH）. Methods Forty-five patients undergoing TAH were randomly divided into 3 groups, namely NS group, L8 group and L16 group with intravenous injection of 4 ml saline, 8 mg LOR, and 16 mg LOR before the induction of anesthesia respectively. Venous blood samples were taken before anesthesia （T0）, at 30 min during the operation （T1）, at the end of the operation （T2）, and at 24 h and 48 h after the operation （T3 and T4, respectively） to determine 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） by enzyme-linked immunosorbent assay （ELISA）. Results The serum RANTES levels in NS group and L8 group at T1-T3 were significantly lower than those at T0 （P〈0.05）, but the levels in L8 group at each time point were all higher than those in NS group NS （P〈0.05）. The serum RANTES levels in L16 group L16 only decreased at T1-T2 as compared to those at T0, and were significantly higher than those in NS group and L8 group （P〈0.05）. The expressions of MCP-1 and SDF-1α in the 3 groups all increased at T1 and reached the peak levels after the operation. In L8 group and L16 group, MCP-1 expression at T2-T3 and SDF-1α at T1-T2 were both significantly lower than those in NS group （P〈0.05）. SDF-1α expression at T1-T2 was significantly lower in L16 group than in L8 group （P〈0.05）. The decrements of MCP-1 and SDF-1α were more obvious in L16 group than L8 group. Conclusion Preoperative intravenous LOR injection may increase serum RANTES level and decrease MCP-1 and SDF-1α expressions to effectively relieve the perioperative immune disorders caused by TAH, and the effect is more potent at the dose of 16 mg.

关 键 词：子宫切除 氯诺昔康 趋化因子 RANTES 单核细胞趋化蛋白-1 基质细胞衍生因子 

分 类 号：R614.2[医药卫生—麻醉学] R713.42[医药卫生—外科学]