曲马多对胃肠道肿瘤患者术中免疫功能的影响  

Effects of tramadol on immune function in gastrointestinal cancer patients

作　　者：吴树宁[1] 丁汉琳[1] 李明强[1] 周立文[1] 雷成明[1] 

机构地区：[1]华中科技大学同济医学院附属襄樊医院麻醉科,襄樊市441021

出　　处：《临床麻醉学杂志》2011年第1期27-29,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察曲马多对胃肠道肿瘤患者术中T淋巴细胞亚群和NK细胞数量的影响。方法 30例胃肠道肿瘤行根治手术的患者随机均分为观察组和对照组。观察组麻醉前肌注曲马多1mg/kg,对照组不使用。于麻醉前、手术1h和术毕抽取外周静脉血,用流式细胞仪检测T淋巴细胞亚群(CD3+、CD3+CD4+、CD3+CD8+)、活化T细胞(CD3+HLA-DR+)和自然杀伤(NK)细胞(CD3-CD16+CD56+)数量的变化。结果两组手术1hCD3+、CD3+CD4+、CD3+CD4+/CD3+CD8+、CD3+HLA-DR+和NK细胞数量均较麻醉前明显下降,对照组明显低于观察组(P<0.05);术毕两组各指标有所回升,但对照组仍明显低于麻醉前水平和观察组(P<0.05)。结论曲马多可减轻胃肠道肿瘤患者术中T淋巴亚群和NK细胞下降的程度,明显改善机体细胞免疫功能的抑制。Objective To observe the effects of tramadol on T-lymphocyte subsets,activated T cells and natural killer（NK）cells in patients undergoing gastrointestinal cancer surgeries.Methods Thirty patients undergoing selective gastric cancer surgeries were randomly divided into 2 groups.Experimental group（E）was given tramadol 1 mg/kg intramuscularly before anesthesia and control group（C）was not.CD3^＋,CD3^＋CD4^＋,CD3^＋CD8^＋,CD3-CD16^＋CD56^＋（NK）cells and CD3^＋HLA-DR^＋（activated T cell）were measured by flow cytometery before anesthesia,at 1 h after incision,and at the end of operation.Results CD3^＋,CD3^＋CD4^＋,CD3^＋CD4^＋/CD3^＋ CD8^＋,CD3^＋CD16^＋CD56^＋ and CD3^＋HLA-DR^＋ cells in two groups were significantly decreased at one hour after incision compared with those before（P〈0.05）,which were lower in group C than those in group E（P〈0.05）and recovered to the baseline in group E but not in group C at the end of surgery.Conclusion Tamadol can improve the cellular immune function by ameliorating the decrese of T-lymphocytes subsets and NK cells in patients undergoing gastrointestinal surgeries.

关 键 词：曲马多 胃肠道肿瘤 T淋巴细胞亚群 NK细胞 

分 类 号：R735[医药卫生—肿瘤]