右美托咪定对结直肠癌手术患者围手术期细胞免疫功能的影响  

Effects of dexmedetomidine on perioperative cellular immunity in patients with colorectal cancer

作　　者：宁雪[1] 吴文峰[1] 李强[1] 

机构地区：[1]广州医学院附属肿瘤医院麻醉科,510095

出　　处：《中华生物医学工程杂志》2012年第4期301-304,共4页Chinese Journal of Biomedical Engineering

基　　金：广东省医学科研基金（A2012279）

摘　　要：目的观察结直肠癌手术患者在全身麻醉过程中使用右美托咪定后围手术期免疫功能的变化。方法选择全身麻醉下行结直肠癌根治术患者40例，随机分为一般全身麻醉组（对照组，n=20）和加用右美托咪定全身麻醉组（试验组，n=20），分别于术前1d、术后24h、术后72h采用流式细胞术检测患者外周血T细胞亚群、NK细胞的绝对数值。结果对照组、试验组两组组内比较患者术后24h及术后72h外周血T细胞亚群、NK细胞绝对计数均较术前1d降低，差异有统计学意义（P〈0．05）；与对照组比较，试验组术后24h及术后72h患者外周血T细胞亚群、NK细胞绝对计数升高，差异有统计学意义[术后72hCD3＋CD4＋淋巴细胞绝对值：试验组（511．85±110．59）细胞／μl，对照组（390．25±128．05）细胞／μl，P〈0．05]。结论右美托咪啶能明显改善结直肠癌患者围手术期T细胞亚群、NK细胞的减少，减轻结直肠癌患者围手术期免疫抑制状态。Objective To determine the variation in cellular immurdty in patients with colorectal cancer treated with dexmedetomidine for general anesthesia during perioperative period. Methods Forty consecutive patients who underwent radical resection of colorectal cancer under general anesthesia were allocated and were randomly assigned into control group （n=20） to receive conventional general anesthesia and treatment group （n=20） to be treated with dexmedetomidine, respectively. Flow cytometry was employed for analysis of the absolute counts of peripheral T lymphocyte subsets and NK cells on day 1 preoperatively, and at hours 24 and 72 postoperatively. Results Both groups yielded lower absolute counts of T lymphocyte subsets and NK cells at hours 24 and 72 postoperatively compared with that on day 1 preoperatively （both P〈 0.05）. The treatment group was associated with higher absolute counts of T lymphocyte subsets and NK cells at hours 24 and 72 postoperatively than control group [For CD3＋CD4＋ lymphocyte absolute count at hour 72 postoperatively, treatment group ： （ 511.85 ± 110.59） cells/μl, control group ： （390.25 ± 128.05 ） cells/pal, P〈 0.051. Conclusion Dexmedetomidine can ameliorate immunity suppression in patients with colorectal cancer via restoring T lymphocyte subsets and NK ceils perioperatively in patients undergoing coloreetal carcinoma resection.

关 键 词：围手术期医护 结直肠肿瘤 细胞免疫 流式细胞术 右美托咪定 

分 类 号：R614[医药卫生—麻醉学]