异丙酚对食管癌患者手术期间血清相关细胞因子的影响  

Effects of propofol on cytokines of for patients under anaesthesia for esophageal cancer

作　　者：程永冲[1] 许昌泰[2] 徐礼鲜 

机构地区：[1]解放军第三医院麻醉科,陕西宝鸡721004 [2]第四军医大学解剖学教研室,陕西西安710032 [3]第四军医大学口腔医院麻醉科,陕西西安710032

出　　处：《武警医学院学报》2011年第4期260-262,共3页Acta Academiae Medicinae CPAPF

基　　金：国家自然科学基金资助项目(39580683)

摘　　要：【目的】研究异丙酚麻醉对食管癌手术患者血清相关细胞因子的影响。【方法】经组织学诊断的食管癌患者66例,按手术时采用的麻醉药物的不同分为异丙酚组(n=35)和依托咪酯组(n=31)。异丙酚组诱导依次采用异丙酚,芬太尼和维库溴铵;而依托咪酯组则采用依托咪酯、芬太尼和维库溴铵。麻醉维持吸入异氟醚,间断追加异丙酚、芬太尼和维库溴铵。术中常规监测心电图,心率、脉搏血氧饱和度、血压等。两组患者均于术前10 min、诱导后10 min、手术开始30 min以及手术结束10 min分别抽取静脉血离心提取血清,用放射免疫法测定丙二醇(MDA)、超氧化物歧化酶(SOD)、白细胞介素-6(IL-6)、肿瘤坏死因子(TNF),血栓素(TX)、内皮素(ET)、前列腺素E(PGE)和降钙素(CT)水平。【结果】两组患者麻醉过程中生命体征平稳,无麻醉相关死亡。术前两组患者血清MDA、SODI、L-6、TNF,TX、ET、PGE和CT均无统计学意义(P>0.05),诱导后异丙酚组上述各指标均明显降低(P<0.05),且随手术时间推延,差异更明显(P<0.01)。【结论】结果提示食管手术采用异丙酚麻醉,能够降低术中血清相关细胞因子水平,从而影响机体的生化代谢,其机理有待进一步探讨。【Objective】 To investigate the effect of propofol on cytokines of patients under anaesthesia for esophageal cancer.【Methods】 A total of 66 histologically diagnosed esophageal cancer patients were enrolled in this study.According to the anaesthesia drug used,cases were divided into propofol group（n = 35） and etomidate group（n = 31）.In propofol group,propofol,fentaini and vecuronium were used in turn for induction and in etomidate group,etomidate,fentaini and vecuronium were used.For anaesthesia maintenance,isoflurane,inhalation was used and propofol,fentaini and vecuronium for interrupted supplement.Electrocardiogram,heart rate,pulse,oxyhemoglobin saturation,blood pressure and so on were routinely monitored during the surgery.Venous blood was collected on pre-operation,after induction,30 minutes after surgery beginning and 10 minutes after surgery for cytokines determination.Serum malonic dialdehyde（MDA）,superoxide dismutase（SOD）,interleukin-6（IL-6）,tumor necrosis factor（TNF）,thromboxane（TX）,endothelin（ET）,prostaglandin E（PGE） and calcitonin（CT） were detemined by radioimmunoassay（RIA）.【Results】 The vital signs were stable in two groups of patients,without anesthesia-related deaths.The serum MDA,SOD,IL-6,TNF,TX,ET,PGE and CT had no statistics significance（P 0.05） for two groups patients in pre-operatively.After induction,the above indicators obviously reduce（P 0.05） in the propofol group,and extended along with the surgery time,the difference was more obvious（P 0.01）.【Conclusion】 TThe results show that the propofol anaesthesia can reduce serum cytokines levels in patients with esophageal cancer surgery,and possibly affect the biochemial metabolism,but its mechanism needs further investigation.

关 键 词：异丙酚 依托咪酯 麻醉 食管癌 血清 细胞因子 

分 类 号：R614.2[医药卫生—麻醉学]