复合麻醉对人外周血淋巴细胞促炎性细胞因子mRNA表达的影响  

Effects of combined anesthesia on proinflammatory cytokine mRNA expression of peripheral blood lymphocyte

作　　者：张光明[1] 蒋豪[1] 薛张纲[1] 方浩[1] 王文逸[2] 瞿涤[2] 

机构地区：[1]复旦大学附属中山医院麻醉科,上海市200032 [2]复旦大学教育部医学分子病毒学重点实验室

出　　处：《临床麻醉学杂志》2002年第2期65-67,共3页Journal of Clinical Anesthesiology

基　　金：国家教委博士点基金资助 (基金号 :9743)

摘　　要：目的　研究复合麻醉中人外周血淋巴细胞IL 8、IL 1 β、TNF α基因表达 ,探讨异氟醚吸入和硬膜外阻滞对外周血炎性反应的影响。方法　 2 4例肝脏部分切除手术病人随机分为异氟醚组(n =1 2 )和硬膜外组 (n =1 2 ) ,在麻醉诱导后即刻和 4小时分别取静脉血 2 0ml用外周血淋巴细胞分离液 (Ficoll)进行梯度离心 ,从获得的淋巴细胞中提取RNA ,逆转录合成cDNA ,PCR后电泳扫描求积 ,检测淋巴细胞IL 8、IL 1 β和TNF α的mRNA表达。 结果　异氟醚组麻醉维持 4小时比麻醉诱导后即刻IL 8、IL 1 β的表达增加 (P <0 0 5) ,硬膜外组麻醉维持 4小时与麻醉诱导后即刻IL 8、IL 1 β的表达无明显变化 (P >0 0 5)。两组均未检出TNF α基因表达。 结论　复合麻醉中吸入异氟醚能增强肝脏部分切除病人外周血淋巴细胞促炎性细胞因子mRNA表达 ,即在转录水平上 ,异氟醚能增强外周血炎性反应 ;Objective To study the changes of interlukin 1 β(IL 1β),IL 8 and tumor necrosis factor α(TNF α) mRNA expression in peripheral blood lymphocytes during combined anesthesia.Methods Patients undergoing hepatectomy were anesthetized with either isoflurane (group I, n= 12)or combined epidural general anesthesia (group E, n= 12).Lymphocytes were harvested by ladder centrifuge of blood immediately and 4h after induction of anesthesia.RNA was extracted from harvested cells and cDNA was synthesized by reverse transcription.Expression of IL 8,IL 1β,and TNF α was measured by semiquantitative polymerase chain reaction using β actin as an internal standard.Results Gene expression of IL 8,IL 1β in lymphocytes increased significantly at 4h after induction of isoflurane anesthesia.There were no significant changes for the expression of the two cytokines during combined epidural general anesthesia.The gene expression of TNF α was not tested in both groups.Conclusion Isoflurane anesthesia can provoke the systemic inflammatory response.There was no inflammatory response during combined epidural general anesthesia.

关 键 词：复合麻醉 促炎性细胞因子 逆转录-聚合酶链反应 硬膜外阻滞 外周血淋巴结巴 

分 类 号：R614[医药卫生—麻醉学]