恩氟烷及异氟烷对食管癌切除术围术期病人外周血T淋巴细胞免疫功能的影响  

Effects of enflurane and isoflurane on the immune function of T-lymphocyte from peripheral blood of the patients undergoing esophagectomy

作　　者：邢玉英[1] 李力兵[1] 张爱玉[1] 徐贯杰[1] 张立生[1] 

机构地区：[1]河北医科大学第四附属医院麻醉,石家庄市050011

出　　处：《中华麻醉学杂志》2000年第12期727-729,共3页Chinese Journal of Anesthesiology

摘　　要：目的　探讨恩氟烷及异氟烷对病人外周血中T淋巴细胞免疫功能的影响。方法　选择 6 0例食管癌病人 ,随机分成 3组 ,Ⅰ组 :恩氟烷组 ,Ⅱ组 :异氟烷组 ,Ⅲ组 :异丙酚组 ,每组 2 0例。Ⅰ、Ⅱ组术中吸入浓度分别维持 1 5 %～ 2 %。Ⅲ组按 4～ 6mg·kg-1·h-1微量泵输入并辅助芬太尼 6～8μg·kg-1。于麻醉前、吸入麻醉药后 90min、术毕、术后 2 4h、72h ,抽取桡静脉血 1ml,采用流式细胞仪测定T3 、T4 、T8淋巴细胞的水平。结果　Ⅱ和Ⅲ组与术前相比 ,T3 、T4 、T8水平均无明显变化 (P >0 0 5 )。Ⅰ组在吸入麻醉药后 90minT8明显下降 (P <0 0 5 ) ,术毕时恢复至术前 ,而术后 2 4h又下降明显 (P <0 0 5 ) ,72h后又恢复至术前。与Ⅲ组相比 ,只有Ⅰ组术毕时T3 淋巴细胞显著抑制 (P <0 0 5 )。结论　异氟烷对肿瘤病人的免疫功能无明显影响。恩氟烷只对T3 及T8细胞有程度很低的、一过性的抑制作用 。Objective To investigate the effects of enflurane and isoflurane on the immune function of T lymphocytes from peripheral blood of the esophagus cancer patients undergoing esophagectomy.Methods Sixty patients were randomly divided into three groups with 20 cases each Anesthesia was maintained with 1 5% 2 0% enflurane or isoflurane in group Ⅰ or Ⅱ respectively Propofol 4 6mg·kg -1 ·h -1 and fentanyl 6 8μg·kg -1 ·h -1 were infused to maintain anesthesia in group Ⅲ Blood samples from radial artery were taken before anesthesia , during operation and 24 h and 72 h after operation, to determine the levels of T 3,T 4 and T 8 lymphocytes by flow cytometry Results Compared with those before anesthesia, the levels of T 3,T 4 and T 8 in group Ⅱ and Ⅲ remained almost unchanged (P>0 05), only T 8 level decreased significantly in group Ⅲ (P<0 05) ,but returned to the baseline levels after operation As compared with that in group Ⅲ, T 3 reduced markedly in group Ⅰ at the end of operation (P<0 05) Conclusions Isoflurane inhalation does not effect the immune function in patients with cancer Enflurane inhalation inhibits only T 3 and T 8 transiently and slightly , indicating that isoflurane and enflurane can be safely applied for inhalation anesthesia in the cancer patients

关 键 词：恩氟烷 异氟烷 食管癌 外科手术 T细胞功能 

分 类 号：R735.1[医药卫生—肿瘤] R730.56[医药卫生—临床医学]