右美托咪定对肺癌手术患者免疫功能和微循环的影响  

Influence of Dextral Metoprolol on Immunologic Function and Microcirculation of Patients Undergoing Lung Cancer Surgery

作　　者：陈英[1] 洪道先[1] 宋直雷[1] 何东海[1] 

机构地区：[1]河南大学第一附属医院麻醉科,河南开封475000

出　　处：《中国药房》2017年第2期225-227,共3页China Pharmacy

基　　金：河南省卫生厅医学科技攻关计划项目(No.201404023)

摘　　要：目的:探讨右美托咪定对肺癌手术患者免疫功能和微循环的影响。方法:选择择期行肺癌手术患者88例,按随机数字表法分为观察组和对照组,各44例。观察组患者麻醉诱导前10 min静脉注射右美托咪定负荷剂量1μg/kg,并以0.6μg/(kg·h)静脉滴注至关胸;对照组患者静脉注射等量0.9%氯化钠注射液。观察两组患者麻醉诱导开始时(T_0)、手术结束即刻(T_1)、术后12 h(T_2)时的CD3^+、CD4^+、CD8^+水平及CD4^+/CD8^+、末梢灌注指数(TPI)、低频功率(LF)/高频功率(HF)值,并比较两组患者不良反应发生情况。结果:T_0时,两组患者CD3^+、CD4^+、CD8^+、CD4^+/CD8^+、TPI、LF/HF比较,差异均无统计学意义(P>0.05)。T_1、T_2时,对照组患者CD3^+、CD4^+、CD4^+/CD8^+、TPI显著降低,且显著低于观察组;CD8^+显著升高,且显著高于观察组;两组患者LF/HF均显著降低,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。观察组患者的CD3^+、CD4^+、CD8^+、CD4^+/CD8^+、TPI治疗前后比较,差异均无统计学意义(P>0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:右美托咪定可有效稳定肺癌手术患者术中的免疫功能和微循环,且不增加不良反应。OBJECTIVE： To explore the influence of dextral metoprolol on immunologic function and nicrocirculation of patients undergoing lung cancer surgery. METHODS： 88 patients undergoing selective lung cancer surgery were selected and divid- ed into observation group and control group according to random number method, with 44 cases in each group. Observation group was given intravenous infusion of dextral metoprolol with loading dose of 1 μg/kg 10 min before anesthesia induction, then at 0.6 μg/（kg·h） until closing the chest; control group was given constant volume of 0.9% Sodium chloride injection with intravenous infusion. The levels of CD3＋, CD4＋, CD8＋ and CD4＋/CD8＋, as well as the TPI, LF/HF ratio were observed in 2 groups at the beginning of anesthesia induction （T0）, immediately after the end of surgery （T0, 12 h after surgery （T2） ; the occurrence of ADR were compared between 2 groups. RESULTS： There was no statistical significance in the levels of CD3＋, CD4＋, CD8＋, CD4＋/ CD8＋, TP1 and LF/HF between 2 groups at T0 （P〉0.05）. At T1 and/2, CD3＋, CD4＋, CD4＋/CD8＋ and TPI of control group were decreased significantly and lower than those of observation group; CD8 ＋ in control group were increased significantly and higher than observation group; LF/HF of both groups were deereased significantly, and the observation group was significantly lower than the control group, with statistical significance （P〈0.05）. There was no statistical significance in CD3＋,CD4＋,CD8＋,CD4＋/CD8＋ and TP1 of observation group before and after treatment （P〉0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P〉0.05）. CONCLUSIONS： Dextral metoprolol can effectively improve the immunologic function and microcirculation of patients during lung cancer surgery with good safety.

关 键 词：右美托咪定 肺癌手术 免疫功能 微循环 

分 类 号：R563.9[医药卫生—呼吸系统]