老年直肠癌患者轻度低温下IL-2、IL-10变化与术后早期认知功能相关性的研究  

The Correlation Between the Elevation of IL-2 and IL-10 Levels Under Mild Hypothermia and Early Postoperative Cognitive Dysfunction in Elderly

作　　者：赵敏[1] 张毅[1] 赵力[1] 王忠彗 

机构地区：[1]昆明医科大学第三附属医院麻醉科,云南昆明650118

出　　处：《昆明医科大学学报》2013年第9期96-101,共6页Journal of Kunming Medical University

摘　　要：目的比较老年直肠癌患者术中轻度低温及正常体温下细胞因子IL-2、IL～10的变化与术后早期认知功能的变化是否具有相关性．方法ASAI-Ⅱ级拟行直肠癌手术老年患者40例，年龄65—83岁，随机均分为常温组（I组）和轻度低温组（Ⅱ组）．分别于麻醉前1h（T1）、手术结束时（蚴及术后24h（T1）用流式细胞仪检测细胞因子IL-2、IL-10；另于术前1d（N1）、术后第1天（N2）及术后第3天（N1）用MMSE量表对患者进行神经精神功能测试并记录得分情况．结果与T1时比较，Ⅱ组IL-2血浆浓度在T1．T2时明显降低（P〈0．01）；与T1、T2时比较，Ⅱ组L时IL-10浓度明显增高（P〈O．01）．与N时比较，2组患者MMSE评分№时下降（P〈O．05），尤以Ⅱ组降低明显，组间比较有差异（P〈0．05）．N2时评分又逐渐升高，与N：比较有差异（P〈0．05）．T2、T1时Ⅱ组IL-2与N2时的MMSE评分存在明显的正相关性（r=0．459，P〈0．01）（r=0．550，P〈0．01）．结论术中轻度低温导致的IL-2降低与老年直肠癌患者术后早期MMSE评分降低存在正相关．Objective To compare the effects of mild hypothermia or normothermia on inflammatory cytokines （IL-2 and IL-10） in elderly patients undergoing surgery for rectal cancer, and determine whether the elevation of IL-2 and IL-IO levels and early postoperative cognitive dysfunction has the relevant. Methods Forty ASA classificationⅠ or Ⅱpatients aged 65-83 yr undergoing surgery for rectal cancer were randomly divided into 2 groups （n=20 each） ： normal body temperature group （Group I ） and mild hypothermia group （Group Ⅱ） The venous blood samples were taken at 3 points which were at 1 h before anesthesia （T1） , the end of operation （T2） and the 24h after operation （T3） to measure the levels of plasma IL-2 and IL-10. The cognitive function test （MMSE） were performed at one day before operation （N1） , one day after operation （N2） and 3th days after operation （N3） Results The level of plasma IL-2 was significantly lower in the Group Ⅱthan that in the Group I at T2 and T3 （P 〈 0.01） , and those was significantly lower at T3 than that at T2 （P 〈 0.01） . The level of plasma IL-10 was significantly higher in the Group [[ at T3 than that at T1 and T2 （P 〈 0.01） . To compare with N1, the score of both groups were decreased at N2 （P 〈 0.05）, and it was lower in Group Ⅱ than that in Group I （P 〈 0.05）, with a significant difference. The score of both groups were increased significantly at N2 （P〈O.05）,and there was significant difference with N2 （P 〈0.05） ; Positive correlation was found between IL-2 at T2 and T3 and the score of MMSE in the GroupⅡ at Nz （r = 0.459, P 〈0.01） （r = 0.550, P 〈0.01） Conclusion Positive correlations were found between the elevation of IL-2 levels under mild hypothermia and the decline of postoperative early cognitive function in elderly undergoing rectal cancer surgery.

关 键 词：老年 低温POCD 细胞因子 

分 类 号：R734.2[医药卫生—肿瘤]