右美托咪定对乳腺癌根治术患者T淋巴细胞亚群及NK细胞的影响  

Effects of Dexmedetomidine on T Lymphocyte Subsets and Natural Killer Cells in Patients Undergoing Radical Excision for Breast Cancer

作　　者：庄海滨[1] 刘金花[1] 谢平[1] 

机构地区：[1]中国人民解放军第180医院麻醉科,福建泉州362000

出　　处：《南昌大学学报（医学版）》2014年第6期38-40,43,共4页Journal of Nanchang University：Medical Sciences

摘　　要：目的探讨右美托咪定对乳腺癌根治术患者T淋巴细胞亚群及NK细胞的影响。方法选择ASAⅠ或Ⅱ级择期全身麻醉下行乳腺癌根治术患者60例,随机分为右美托咪定组(D组)和对照组(C组),每组30例。D组于麻醉诱导前15min经静脉输注右美托咪定1.0μg·kg-1,继而以0.5μg·kg-1·h-1的速率维持至术毕,C组给予等容量生理盐水。分别于麻醉诱导前(T0)、手术开始后2h,术后6、24h及3、7d(T1-T5)6个时点采集静脉血样,采用流式细胞仪检测T淋巴细胞亚群(CD+3、CD+4、CD+8)及NK细胞浓度,并计算CD+4/CD+8比值。结果与C组比较,D组T1-T3时CD+3、CD+4、NK细胞浓度及CD+4/CD+8比值升高(P<0.05),CD+8水平各时点比较差异无统计学意义(P>0.05);与T0时比较,T1-T4时2组患者CD+3、CD+4、NK细胞浓度及CD+4/CD+8比值降低(P<0.05),T5时差异无统计学意义(P>0.05)。结论右美托咪定对乳腺癌根治术患者T淋巴细胞亚群和NK细胞具有保护作用,可减轻围术期细胞免疫功能抑制。Objective To investigate the effects of dexmedetomidine on T lymphocyte subsets and natural killer（NK）cells in patients undergoing radical excision for breast cancer.Methods Sixty ASA ⅠorⅡpatients scheduled for elective modified radical mastectomy under general anesthesia were randomly divided into two groups,with 30patients in each group.Patients in dexmedetomidine group（group D）were given intravenous infusion of dexmedetomidine at 1μg·kg-1 15minutes before anesthesia induction,followed by intravenous infusion of dexmedetomidine at 0.5μg·kg-1/hour until the end of surgery.Patients in control group（group C）were given the same volume of normal saline.Venous blood samples were collected before anesthesia induction of（T0）,2hours after the beginning of operation（T1）,6hours after operation（T2）,24hours after operation（T3）,3days after operation（T4）and 7days after operation（T5）.T-lymphocyte subsets（CD＋3,CD＋4and CD＋8）and NK cells were measured by flow cytometry and CD＋4/CD＋8ratio was calculated.Results Compared with group C,levels of CD＋3,CD＋4and NK cells and ratio of CD＋4/CD＋8significantly increased in group D at T1-T3（P〈0.05）.There were no significant differences in levels of CD＋8cells among different time points（P〉0.05）.Compared with T0,levels of CD＋3,CD＋4and NK cells and ratio of CD＋4/CD＋8significantly decreased at T1-T4in both groups（P〈0.05）.No significant differences in these parameters were found between T0and T5（P〉0.05）.Conclusion Dexmedetomidine exerts a protective effect on T lymphocyte subsets and NK cells and alleviates perioperative immunosuppression in patients undergoing radical excision for breast cancer.

关 键 词：右美托咪定 乳腺肿瘤 T淋巴细胞亚群 NK细胞 免疫功能 

分 类 号：R730.51[医药卫生—肿瘤]