亚麻醉剂氯氨酮对肺手术围术期细胞因子的影响  

Effect of sub-anesthetic dose of ketamine on the cytokine production in the perioperative period

作　　者：刘刚[1] 王彩珠[1] 徐宁[1] 陈敏敏[1] 劳燕萍[1] 

机构地区：[1]广州市胸科医院,广东广州510095

出　　处：《临床肺科杂志》2011年第11期1663-1665,共3页Journal of Clinical Pulmonary Medicine

基　　金：广州市医药卫生科技一般引导项目(编号2008-YB-217)

摘　　要：目的探讨亚麻醉剂氯氨酮在肺手术围术期对细胞因子产生的影响。方法肺大疱切除修补术的气胸患者40例,均分为氯胺酮组(K组)和对照组(C组)。麻醉后手术前给予K组病人氯胺酮并持续静脉滴注至手术结束,对照组采用生理盐水代替氯氨酮,在手术前、术后4 h、24 h、48 h及72 h分别测定IL-1β、IL-2、IL-6和TNF-α的血清浓度。结果术后24 h、48h、72 h,C组病人IL-2水平显著下降,而在K组IL-2能维持在术前水平。术后4 h C组IL-6分泌增加,与K组相比有统计学意义(P<0.05);术后4 h K组TNF-α产生的量与术前相似,而在C组显著增加(P<0.05)。结论麻醉后手术前给予亚剂量氯氨酮能减弱促炎因子IL-6和TNF-α的产生。Objective To study effect of sub-anesthetic dose of ketamine on the cytokine production in the perioperative period.Methods The patients with pneumothorax,who were given bulla excision repair,were randomly selected 40 patients who were divided into two groups： ketamine group（K group） and control group（C group）.The patients in K group were given ketamine by intravenous injection and continuous infusion after induction of anesthetic,before operation until end of the operation.The patients in C group were given physiological saline instead of ketamine.The serum concentrations of IL-1β,IL-2,IL-6 and TNF-α in all the patients of two groups were measured by ELISA before surgery,after 4h,24 h,48 h and 72 h.Results Postoperative 24 h,48 h,72 h,the level of IL-2 in the patients of C group significantly decreased,while its level in the patients of K group maintained the preoperative level.Postoperative 4h,IL-6 secretion in the C group increased,while there not was increase in the K group,and a statistical difference in IL-6 levels was found between the two group（P〈0.05）.Postoperative 4 h,the amount of TNF-α production in K group was similar to that preoperative,while in C group increased significantly（P〈0.05）.Conclusions The patients are given sub-dose ketamine after induction of anesthetic,before operation which may decrease proinflammatory cytokine IL-6 and TNF-α production,make IL-2 maintain at the preoperative level.

关 键 词：氯胺酮 细胞因子 肺手术 

分 类 号：R614[医药卫生—麻醉学]