早期使用曲马多镇痛对烧伤患者外周血Th17和Treg细胞比例的影响  

Effect of early use of tramadol analgesia on the propotions of Th17 and Treg cells in peripheral blood of burn patients

作　　者：张中军[1] 邹俊[1] 毛洪雅 项舒玮[1] ZHANG;Zhongjun;ZOU Jun;MAO Hongya(Department of Anaesthesia,Third People's Hospital of Wuxi ,Wuxi214041,CHINA)

机构地区：[1]无锡市第三人民医院麻醉科,江苏214041

出　　处：《江苏医药》2018年第11期1254-1256,共3页Jiangsu Medical Journal

摘　　要：目的探讨早期使用曲马多镇痛对大面积烧伤患者外周血Th17和调节性T细胞(Treg细胞)数量的影响。方法烧伤面积≥30%总体表面积30例患者均分为两组,采用相同常规治疗。A组入院即刻输注曲马多100mg,B组输注等量生理盐水作为对照;另选10例健康志愿者为空白对照(C)组。于入院即刻(T1)、伤后24h(T2)和伤后7d(T3)抽取外周静脉血(C组仅采血1次),用流式细胞术检测Th17细胞以及Treg细胞,并评估VAS疼痛评分。结果 A组T2、T3时的VAS疼痛评分均低于B组(P<0.01)。A、B组T1、T2时的外周血Th17细胞比例均高于C组(P<0.01);A组T3时的Th17细胞比例低于T1、T2(P<0.05),高于B组(P<0.01)。A、B组T1、T2时的Treg细胞比例均低于C组(P<0.01);A组T3时的Treg细胞比例高于B组(P<0.01)。结论大面积烧伤患者烧伤后早期使用曲马多镇痛能减轻细胞免疫抑制。Objective To investigate the effect of early use of tramadol analgesia on the number of Th17 cells and Treg cells in peripheral blood of the patients with extensive burn.Methods Thirty patients with burn area≥30%total body surface area were randomly assigned into two groups with15 cases each,who were treated with same conventional therapies.Ten healthy volunteers were selected as the blank controls(group C).Tramadol 100 mg was infused immediately on admission in group A and equal volume normal saline was infused in group B.Th17 cells and Treg cells in peripheral blood were detected with flow cytometry immediately after admission(T1),at 24 hours(T2)and 7 days after injury(T3).VAS pain scores were evaluated as well.Results The VAS pain scores at T2 and T3 were significantly lower in group A than those in group B(P<0.01).The percentages of Th17 cells in peripheral blood at T1 and T2 were significantly higher in groups of A and B than those in group C(P<0.01).The percentage of Th17 cells in peripheral blood at T3 was significantly lower than that at T1 and T2 in group A(P<0.05),but higher than that in group B(P<0.01).The percentages of Treg cells in peripheral blood at T1 and T2 were significantly lower in groups of A and B than those in group C(P<0.01).The percentage of Treg cells in peripheral blood at T3 was significantly higher in group A than that in group B(P<0.01).Conclusion Early use of tramadol analgesia can alleviate the cellular immunosuppression in the patients with extensive burns.

关 键 词：曲马多 烧伤 辅助性T细胞17 调节性T细胞 

分 类 号：R614[医药卫生—麻醉学]