右美托咪定对食管癌患者围术期Th17细胞功能的影响  

Effect of dexmedetomidine on Th17 cell function in patients with esophageal carcinoma during the perioperative period

作　　者：高伦明[1] 

机构地区：[1]四川省攀枝花市中西医结合医院,四川攀枝花617000

出　　处：《现代中西医结合杂志》2016年第36期4019-4022,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察右美托咪定对食管癌患者围术期Th17细胞功能的影响。方法将60例拟行食管癌根治术患者随机分为观察组和对照组各30例,2组术前30 min均给予东莨菪碱联合度冷丁肌肉注射。观察组诱导前静脉泵入右美托咪定,对照组用同等体积的生理盐水替代,2组均使用芬太尼3μg/kg+维库溴铵0.1 mg/kg+异丙酚2 mg/kg进行诱导,检测2组术前(t_0)、术毕(t_1)、术后24 h(t_2)、术后48 h(t_3)的Th17细胞频率、NK细胞活性及外周血IL-6、IL-8和IL-23水平。结果 2组手术输液量、手术时间、术中出血量比较差异均无统计学意义(P均>0.05)。t0时2组Th17细胞表达率和NK细胞活性比较差异均无统计学意义(P均>0.05);t1时2组Th17细胞表达率均明显高于t_0时(P均<0.05),且对照组上调的趋势更为明显(P<0.05);t_2时2组Th17细胞表达率继续上调,其中对照组增加的幅度较观察组明显(P<0.05);t_3时2组Th17细胞表达率均明显低于t_2时(P均<0.05),且观察组Th17细胞表达率明显低于对照组(P<0.05)。t_1时2组NK细胞活性均明显高于t0时(P均<0.05),且观察组明显高于对照组(P<0.05);t_2时观察组NK细胞活性虽然较t_1时降低但仍高于t0时(P<0.05),而对照组NK细胞活性与t0时比较差异无统计学意义(P>0.05);t_3时2组NK细胞活性与t0时比较差异均无统计学意义(P均>0.05)。t_1时2组IL-6、IL-8和IL-23水平均明显高于t0时(P均<0.05),但观察组各指标水平均明显低于对照组(P均<0.05);t_2时2组IL-6、IL-23水平及对照组IL-8水平仍持续升高(P均<0.05),但观察组各指标水平均明显低于对照组(P均<0.05),观察组IL-8出现下降趋势;t3时2组IL-6、IL-8和IL-23水平仍高于t0时(P均<0.05),但观察组上述指标水平均明显低于对照组(P均<0.05)。结论右美托咪定可能通过调节Th17细胞功能达到减轻食管癌患者围术期的应激反应及免疫抑制的目的。Objective It is to observe the influence of dexmedetomidine on Th17 cell function in patients with esophageal carcinoma in the perioperative period. Methods Sixty cases of patients with esophageal cancer undergoing radical resection were divided into observation group and control group with 30 eases in each group. All the patients were given intramuscular injection of scopolamine combined with dolantin in the two groups at preoperative 30 min. The patients were treated with intravenous infusion of dexmedetomidine in the observation group before induction and with the same volume of normal saline instead in the control group. The anesthesia were induced by 3 μg/kg fentanyl ＋ 0.1 mg/kg vecuronium ＋ 2 mg/kg propofol in the two groups. The frequency of Th17 cells, natural killer （NK） cell activity, and the levels of IL- 8, IL- 6, IL- 23 were detected in the two groups before operation （to ） , at the end of operation （t1 ） , postoperative 24 h （t2 ） and Postoperative 48 h （t3 ）. Results There was no significant difference between the two groups in the operative infusion volume, the time of operation, the amount of bleeding during the operation （ all P 〉 0.05 ）. There was no significant difference in the expression rate of Th17 and NK cell activity between the two groups at to （ all P 〉 0.05 ） ; at t1, the expression rate of Th17 cells in the two groups were significantly higher than that at to （ all P 〈 0.05 ） , and the upward trend of the control group was more obvious （P 〈 0. 05） ; at t2 , the expression rate of Th17 cells in the two groups continued to increase, while the increase in the control group was significantly higher than that in the observation group （P 〈 0.05） ; at t3 , the expression rate of Th17 cells in the two groups were significantly lower than that in the groups at t2 （ all P 〈 0.05 ）, and the expression rate of Th17 cells in the observation group was significantly lower than that in the control group （P 〈 0.05 ）. At t1, the NK cel

关 键 词：食管癌 TH17细胞 NK细胞 细胞因子 右美托咪定 

分 类 号：R969.4[医药卫生—药理学]