七氟醚麻醉对肝炎肝硬化手术患者T淋巴细胞亚群的影响  

Infiuence of anesthesia with sevoflurane on T lymphocyte subsets in surgical patients with hepatitis-induced liver cirrhosis

作　　者：殷国平[1] 张维峰[1] 王佳[1] 仲艳玲[1] 邓友明[1] 

机构地区：[1]东南大学附属南京第二医院麻醉科,江苏省210003

出　　处：《江苏医药》2014年第23期2870-2872,共3页Jiangsu Medical Journal

基　　金：2011年度南京市医药卫生科研课题(YKK11081)

摘　　要：目的探讨七氟醚麻醉对肝炎肝硬化手术患者围术期免疫功能的影响。方法择期行脾切除断流手术的肝炎肝硬化患者40例随机均分为两组,分别采用2%-4%七氟醚吸入(S组)和丙泊酚3-6mg·kg-1·h-1泵注(P组)维持麻醉。分别于麻醉前30min、术毕及术后1d用ELISA法测定血清IL-2、可溶性IL-2受体(sIL-2R)和INF-γ水平。结果两组术毕时IFN-γ水平均低于麻醉前(P<0.05);术后1d有所恢复,但P组仍低于S组(P<0.05)。两组术毕sIL-2R水平均低于麻醉前(P<0.05);术后1d开始恢复,但P组仍低于麻醉前和S组(P<0.05)。两组麻醉前后血清IL-2水平均无统计学差异(P>0.05)。结论七氟醚吸入麻醉对脾切断流术的肝炎肝硬化患者免疫功能抑制较丙泊酚静脉麻醉轻。Objective To explore the impact of aanesthesia with sevoflurane on immune function of surgical patients with hepatitis-induced liver cirrhosis. Methods Forty patients with hepatitis-induced liver cirrhosis undergoing splenectomy and devascularization were randomly assigned into 2 groups with 20 cases each. The general anesthesia was maintained with 2%-4% sevoflurane inhalation in group S and with propofol 3-6 mg · kg-1· h-1 in group P. Venous blood samples were collected before anesthesia（T0）, at the end of surgery（T1） and one day after surgery（T2） for the measurements of interferon gamma（INF-7）, interleukin-2 （IL-2） and soluble IL-2 receptor（sIL-2R） by ELISA. Results Serum levels of IFN-7 were lower at T1 than those at TO in both groups（P〈0. 05）, which at T2 were recovering, but were lower in group P than those in group S（P〈0. 05）. Serum levels of sIL-2R were lower at T1 than those at TO in both groups（P〈0. 05） ,which at T2 were recovering, but were still lower in group P than those at TO and in group S（P〈0. 05）. Serum levels of IL-2 were not significantly different among TO, T1 and T2 in both groups（P〉0. 05）. Conclusion The inhibitory effect of sevoflurane inhalation anesthesia on cell immune function is less than that of propofol infusion in the patients with hepatitis-induced liver cirrhosis undergoing splenectomy and devascularization.

关 键 词：免疫功能 T淋巴细胞亚群 七氟醚 丙泊酚 肝炎肝硬化 

分 类 号：R614[医药卫生—麻醉学]