阿芬太尼对单肺通气患者围术期炎症细胞因子IL-6、IL-10及其mRNA表达的影响  

Effects of Alfentanil on interleukin-6,interleukin-10 and expression of their mRNA in patients undergoing one lung ventilation

作　　者：谢平[1] 帅训军[1] 艾登斌[1] 范金鑫[1] 李兆国[1] 

机构地区：[1]山东青岛市市立医院麻醉科,山东青岛266011

出　　处：《中国现代医学杂志》2013年第11期84-87,共4页China Journal of Modern Medicine

摘　　要：目的观察阿芬太尼对单肺通气(OLV)患者围术期炎症细胞因子白细胞介素-6(IL-6)和白细胞介素-10(IL-10)及其mRNA表达的影响。方法择期拟行肺叶切除术肺癌患者24例,ASAⅠ级或Ⅱ级,年龄43～68岁,BMI 18.9～24.9 kg/cm2。随机分为两组:芬太尼组(F组)和阿芬太尼组(AF组),每组12例。麻醉诱导:两组均静脉注射咪唑安定0.03 mg/kg、吸入8%七氟醚、F组给予芬太尼3μg/kg(AF组给予阿芬太尼18μg/kg)。麻醉维持:间断静脉注射维库溴铵0.04～0.08 mg/kg,F组给予芬太尼0.05～0.10 mg,AF组给予阿芬太尼0.3～0.6 mg,七氟醚呼气末浓度维持在1.8%～2.7%。麻醉维持期间将BIS值维持在40～60。两组均在麻醉诱导后切皮前(T0)、单肺通气60 min(T1)、膨肺后60 min(T2)采取血样测定IL-6和IL-10浓度及其mRNA的表达。结果与F组比较,AF组血浆IL-6浓度、IL-6 mRNA表达、IL-6/IL-10比值和IL-6 mRNA/IL-10mRNA比值于T1、T2均明显降低(P<0.05);AF组血浆IL-10浓度、IL-10 mRNA表达于T1、T2均显著升高(P<0.05)。AF组各时点IL-6/IL-10比值和IL-6 mRNA/IL-10 mRNA比值无明显变化(P>0.05)。结论阿芬太尼应用于单肺通气患者可有效抑制IL-6的生成和释放,促进IL-10的生成和释放,有助于维持IL-6/IL-10的平衡状态,有利于患者预后。【Objective】 To investigate the effects of Alfentanil on interleukin-6,interleukin-10 and their mRNA in patients undergoing one lung ventilation（OLV）.【Methods】 Twenty-four ASA Ⅰ or Ⅱ patients with lung cancer of both sexes aged 43 ～ 68 yr,BMI 18.9 ~ 24.9 kg/cm 2,undergoing elective lung resection were randomly divided into two groups（n =12 each）： group ⅠFentanyl（F） and group Ⅱ Alfentanil（AF）.Anesthesia was induced with Midazolam 0.03 mg/kg,Fentanyl 3 μg/kg（or Alfentanil 18 μg/kg） and 8% Sevoflurane,and maintained with intermittent iv boluses of vecuronium 0.04 ～ 0.08 mg/kg,Fentanyl 0.05 ～0.10 mg（or Alfentanil 0.3 ～ 0.6 mg） and 1.8% ～ 2.7% Sevoflurane in two groups.The BIS value was maintained in the 40 ～ 60 during the maintenance of anesthesia.Blood sample were taken before skin incision（T 0）,60 min after OLV（T 1）,60 min after lungs were inflated（T 2） for deter mination of IL-6,IL-10 concentration and expression of their mRNA.【Results】 IL-6 level,IL-6 mRNA,IL-6 / IL-10 ratio and IL-6 mRNA / IL-10 mRNA ratio were lower significantly in group AF than those in group F;IL-10 level and its mRNA were higher remarkably in group AF than those in group F（P 0.05）.IL-6 / IL-10 ratio and IL-6 mRNA / IL-10 mRNA ratio were not significantly different at all time points in group AF（P 0.05）.【Conclusion】 Alfentanil is effective in inhibiting the production of IL-6 and stimulating the production of IL-10,moreover,Alfentanil can maintain a relative stability of IL-6 / IL-10 in patients undergoing OLV.

关 键 词：阿芬太尼 单肺通气 IL-6 IL-10 mRNA 

分 类 号：R614.2[医药卫生—麻醉学]