右美托咪定对老年肿瘤患者细胞免疫功能的影响  

Effects of dexmedetomidine on cellular immune in elderly patients with cancer

作　　者：刘丽[1] 唐俊[1] 徐威[1] 陈亚萍[1] 

机构地区：[1]复旦大学附属金山医院麻醉科,上海市200540

出　　处：《老年医学与保健》2013年第5期282-284,共3页Geriatrics & Health Care

基　　金：上二海市金山区科委资助项目（2011-03-05）

摘　　要：目的观察右美托咪定（dexmedetomidine，DEX）对老年胃肠道肿瘤患者术中T淋巴细胞亚群和自然杀伤细胞（natural killer，NK）数量的影响。方法40例胃肠道肿瘤根治手术的老年患者随机分为观察组和对照组。观察组麻醉前静脉给予负荷剂量DEX0．5μg／kg，术中以DEX0．3μg／kg·h。维持，对照组静脉给予0．9％氯化钠。于麻醉前、手术开始后1h、手术结束后1h及术后24h抽取外周静脉血，用流式细胞仪检测T淋巴细胞亚群（CD3＋、CD4＋、CD8＋）和NK细胞的变化。结果两组手术开始后1h、手术结束后1h，CD3＋、CD4＋、CD4＋／CD8＋和NK细胞均较麻醉前下降，对照组低于观察组（P〈0．05）；术后24h，两组各指标有所回升，但对照组仍低于麻醉前水平和观察组（P〈0．05）。结论右美托咪定可减轻老年胃肠道肿瘤患者术中T淋巴亚群和NK细胞下降的程度，改善机体细胞免疫功能的抑制。Objective To observe the effect of dexmedetomidine on the population of T-lymphocyte subsets and natural killer （NK） cells in elderly patients undergoing gastrointestinal cancer surgeries. Methods Forty elderly patients undergoing selective gastrointestinal cancer surgeries were randomly allocated into experimental and control groups. Patients in the experimental group was given dexmedetomidine with preoperative loading dose of 0.5 p.g/kg followed by intraoperative maintenance dose of 0.3 μg/kg. h-1, while the same capacity of saline was given to patients in the control group. The numbers of CD3＋ , CD4＋, CD8＋ and NK cells were measured using flow cytometery before anesthesia, 1 h after incision, end of operation and 24 h later. Results The numbers of CD3＋, CD4＋, CD4＋/CD8＋ and NK cells in both groups significantly decreased one hour after incision, end of operation （P〈0.05）, with more severe in the control group （P〈0.05）. All measured populations in the experiment group restored the baseline values 24 h after surgeries, while the control group did not. Conclusion Dexmedetomidine is favorable for the stability of the cellular immune of elderly patients undergoing gastrointestinal surgeries by reducing the decline of T-lymphocytes subsets and NK cells.

关 键 词：右美托咪定 老年肿瘤患者 T淋巴细胞亚群 NK细胞 

分 类 号：R730.51[医药卫生—肿瘤]