依托咪酯静脉麻醉对腹部手术老年患者血清炎症因子的影响  

Effect of Etomidate on inflammatory cytokines in elderly patients with abdominal surgery

作　　者：江伟[1] 税春玲[1] 宋世兰[1] 杨建平[1] 

机构地区：[1]重庆医科大学附属永川医院麻醉科,重庆402160

出　　处：《中国医药导报》2016年第7期64-67,共4页China Medical Herald

基　　金：重庆市永川区科委科研资助项目(YCSTC;2012BE5014)

摘　　要：目的探讨依托咪酯静脉麻醉对腹部手术老年患者血清炎症因子的影响。方法选择2013年8月2014年1月重庆医科大学附属永川医院全麻下行腹部手术的老年患者40例,采用随机数字表法将其分为E组和P组,各20例。两组均采用气管插管全麻,E组采用依托咪酯全凭静脉麻醉,P组采用丙泊酚全凭静脉麻醉。分别于术前24 h（T1）、手术结束时（T2）、术后2 h（T3）、术后24 h（T4）抽取患者外周静脉血5 m L,采用酶联免疫吸附实验测定白细胞介素-6（IL-6）、白细胞介素-10（IL-10）和肿瘤坏死因子-α（TNF-α）的浓度。结果两组患者T2、T3和T4时点血清IL-6、IL-10浓度均较T1时点显著升高（P〈0.01）,T2、T3时点血清TNF-α浓度较T1时点显著升高（P〈0.01）,而T4时点与T1时点比较差异无统计学意义（P〉0.05）;两组患者T3时点较T2时点及T4时点较T3时点血清IL-6和TNF-α浓度均显著降低（P〈0.01）,T3时点血清IL-10浓度较T2时点升高（P〈0.05）;T4时点血清IL-10浓度较T3时点明显降低（P〈0.01）。E组T2和T3时点的血清IL-6和TNF-α浓度较P组显著增高（P〈0.05）,IL-10浓度较P组显著降低（P〈0.05）;两组间其余各时点血清IL-6、IL-10和TNF-α浓度比较差异均无统计学意义（P〉0.05）。结论依托咪酯抑制促炎因子的释放和促进抑炎因子分泌的作用较丙泊酚弱,且作用时间较短,在术后24 h无差异。Objective To evaluate the effect of Etomidate on inflammatory cytokines after abdominal surgery in elderly patients. Methods From August 2013 to January 2014, 40 elderly patients underwent elective abdominal surgery in Affiliated Yongchuan Hospital of Chongqing Medical University were selected, who were randomly divided into group E（Etomidate total intravenous anesthesia） and group P（Propofol total intravenous anesthesia） by random number table method,20 cases in each group. 5 m L peripheral venous blood were respectively collected in time of before induction of anesthesia（T1）, ending of operation（T2）, 2 h（T3） and 24 h postoperatively（T4）. The interleukin 6（IL-6）, interleukin 10（IL-10）and tumor necrosis factor α（TNF-α） were measured by enzyme linked immunosorbent assay. Results Compared with T1, the concentration of IL-6 and IL-10 in both groups were raised at T2, T3 and T4（P 〈 0.01）, the concentration of TNF-αat T2 and T3in both groups were significantly elevated（P 〈 0.01）, but there was no significant difference in the concentration of TNF-α between T4 and T1（P 〉 0.05）. The concentrations of IL-6 and TNF-α in two groups at T3 were lower than those at T2, and T4 were lower than those at T3（P 〈 0.01）, the concentrations of IL-10 in two groups at T3 were higher than those at T2（P 〈 0.05）, while that at T4 were lower those those at T3（P 〈 0.01）. The concentrations of IL-6 and TNF-α in group E at T2 and T3were higher than those in group P（P 〈 0.05）, but the concentrations of IL-10 in group E at T2 and T3were lower than those in group P（P 〈 0.05）; there were no significant differences in concentrations of IL-6,IL-10 and TNF-α of the two groups at the other time points（P 〉 0.05）. Conclusion The effect of decrease of inflammatory cytokines and increase of anti-inflammatory cytokines by Etomidate intravenous anesthesia is lower than Propofol intravenous anesthesia, this effect is temporary and has no difference at 24 h posto

关 键 词：依托咪酯 老年患者 炎症因子 全凭静脉麻醉 

分 类 号：R614.2[医药卫生—麻醉学]