感染性休克患者采用丙泊酚与依托咪酯麻醉对细胞免疫功能的影响研究  

Influence of propofol and etomidate anesthesia on cellular immune function in patients with septic shock

作　　者：马婷婷[1] 胡兵伟 周程[1] 朱华东[1] 李奇[1] 

机构地区：[1]浙江省立同德医院麻醉科,浙江杭州310012

出　　处：《中华医院感染学杂志》2016年第12期2682-2684,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生计划基金资助项目(2013KYA102)

摘　　要：目的研究丙泊酚与依托咪酯麻醉对感染性休克患者细胞免疫功能的影响,为选择合适的麻醉方式提供依据。方法选取2010-2015年于医院诊治的90例感染性休克患者资料进行分析,采用随机对照方法将患者分为对照组和试验组,每组各45例,对照组采用丙泊酚麻醉,试验组采用依托咪酯麻醉,比较两组麻醉方法对患者免疫功能的影响及药物不良反应。结果两组患者麻醉前CD3^+、CD_4^+指标比较,差异无统计学意义;两组患者麻醉后CD3^+、CD_4^+指标均出现下降趋势,试验组手术后、术后1d以及3d的CD3^+、CD_4^+水平,均显著高于对照组,差异有统计学意义(P<0.05);两组患者麻醉前CD_8^+以及CD_4^+/CD_8^+比值,差异无统计学意义;试验组手术后、术后1d以及3d的CD_8^+、CD_4^+/CD_8^+比值,均显著高于对照组,差异有统计学意义(P<0.05);试验组药物不良反应发生率为8.8%,显著高于对照组的20.0%,差异有统计学意义(P<0.05)。结论感染性休克患者采用依托咪酯麻醉效果理想,对机体细胞免疫功能影响较小,且麻醉不良反应发生率低,值得临床推广应用。OBJECTIVE To study the influence of propofol and etomidate anesthesia on cellular immune function in patients with septic shock,so as provide the basis for the selection of the appropriate anesthesia way.METHODS Selected the diagnosis and treatment Clinical data of 90 cases of septic shock patients were analyzed in Zhejiang Tongde Hospital from Jan.2010 to 2015.The patients were randomly divided into control group using propofol anesthesia and experimental group using etomidate anesthesia（each n=45）.The immune function of patients and adverse drug reactions between the two groups were compared.RESULTS The two groups of patients before anesthesia The CD3^＋and CD_4^＋indexes showed no significant difference between the two groups before anesthesia,and both had declining trend after anesthesia.The CD3^＋and CD_4^＋indexes of experimental group after operation,1day and 3days after operation were significantly higher than those of control group（P〈0.05）.The CD_8^＋and CD_4^＋/CD_8^＋ratio had no significant difference between the two groups of patients before anesthesia.The CD_8^＋and CD_4^＋/CD_8^＋ratio of experimental group after operation,1day and 3days after operation were significantly higher than those of control group（P〈0.05）.The adverse drug reaction of experimental group was 8.8%,significantly higher than that of control group（20.0%,P〈0.05）.CONCLUSION Etomidate anesthesia of septic shock patients had ideal effects and little influence on the immune function,with a low incidence of adverse effects of anesthesia,which should be widely applied.

关 键 词：丙泊酚 依托咪酯 感染性休克 免疫功能 影响 

分 类 号：R631.4[医药卫生—外科学]