术前输注氟比洛芬酯对肺癌根治术患者围术期免疫功能及血清β-EP、HMGB1水平的影响  

Effect of preoperative infusion of flurbiprofen axetil on perioperative immune function and serum β-EP and HMGB1 level of patients undergoing the radical procedure for lung cancer

作　　者：苏喆[1] 张光明[1] 

机构地区：[1]上海交通大学医学院附属同仁医院麻醉科,上海200336

出　　处：《实用药物与临床》2017年第3期268-271,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨术前输注氟比洛芬酯对肺癌根治术围术期患者免疫功能及血清β-EP、HMGB1水平的影响。方法选取36例择期行肺癌根治术患者(ASAⅠ~Ⅱ级),分为观察组和对照组,每组18例,观察组术前10 min静脉输注氟比洛芬酯1.5 mg/kg,对照组术前10 min静脉输注等容量生理盐水。采用视觉模拟评分法(Visual analogue scale,VAS)评价术后2、12、24、48 h的镇痛效果;分别于麻醉诱导前30 min(T_0)、术后24 h(T_1)和术后72 h(T_2)检测外周静脉血T淋巴细胞亚群(CD3^+、CD4^+、CD8^+和CD4^+/CD8^+)以及血清β-内啡肽(β-endorphin,β-EP)、高迁移率族蛋白B1(High mobility group box 1 protein,HMGB1)水平。结果与对照组比较,术后2、12、24 h时,观察组VAS评分明显降低(P<0.05);与T_0时比较,两组T_1时CD3^+、CD4^+、CD4^+/CD8^+水平明显降低(P<0.05或P<0.01),且观察组T_1时CD3^+、CD4^+、CD4^+/CD8^+下降幅度明显小于对照组(P<0.05);观察组T_2时CD3^+、CD4^+水平基本恢复至T_0时水平,而对照组CD3^+、CD4^+水平明显低于T_0时水平(P<0.05);两组T_2时CD4^+/CD8^+水平仍低于T_0时水平(P<0.05或P<0.01);观察组T_2时CD3^+、CD4^+、CD4^+/CD8^+水平明显高于对照组(P<0.05);对照组T_1、T_2时血清β-EP水平明显高于T_0时(P<0.05或P<0.01);对照组T_1、T_2时血清β-EP水平均高于观察组(P<0.05);观察组各时间点血清β-EP水平比较,差异无统计学意义(P>0.05);两组T_1时血清HMGB1水平明显高于T_0时(P<0.05),对照组T_2时血清HMGB1水平明显高于T_0时(P<0.05);观察组T_1、T_2时HMGB1水平明显低于对照组(P<0.05)。结论肺癌根治术患者围术期术前输注氟比洛芬酯可抑制术后应激反应,保护机体免疫功能,对机体免疫功能的保护作用可能与其能降低血清β-EP、HMGB1水平增高幅度有关。Objective To investigate the effects of preoperative infusion of flurbiprofen axetil on perioperative immune function and serum β-endorphin（β-EP） and high mobility group box 1 protein（HMGB1） level of patients undergoing the radical procedure for lung cancer.Methods Thirty-six patients who were subjected to scheduled radical surgery for lung cancer（ASA Ⅰ~Ⅱ stage） were randomly divided into two groups：observation group（n = 18） and control group（n = 18）.Patients in observation group received 1.5 mg/kg infusion of flurbiprofen axetil at 10 min before operation,while patients in control group were given the equal volume of normal saline.Visual analog scale（VAS） was conducted at 2 h,12 h,24 h and 48 h after operation.The peripheral venous blood was collected before induction of anesthesia（T_0）,24 h after surgery（T_1） and 48 h after surgery（T_2）.The levels of T lymphatic cells（CD3~＋,CD4~＋,CD8~＋ and CD4~＋/CD8~＋） and serum β-EP and HMGB1 were tested.Results Compared with control group,VAS score was lower in observation group at 2 h,12 h and 24 h after operation（P0.05）.Compared with T_0,CD3~＋,CD4~＋,CD4~＋/CD8~＋ were significantly lower at T_1 in both groups（P0.05 or P0.01）.The decrease in CD3~＋,CD4~＋,CD4~＋/CD8~＋ in observation group was less than that of control group at T_1（P0.05）.CD3~＋,CD4~＋at T_2 in observation group returned to the baselines（T_0）,while CD3~＋,CD4~＋ were still lower at T_2 in control group（P0.05）.CD4~＋/CD8~＋ at T_2 in both groups was still lower than at T_0（P0.05 or P0.01）;CD3~＋,CD4~＋,CD4~＋/CD8~＋ at T_2 in observation group were significantly higher than those of control group（P0.05）.Compared with T_0,the level of serum β-EP was higher at T_1 and T_2 in control group（P0.05 or P0.01）.Compared with observation group,the level of serum β-EP was higher at T_1 and T_2 in control group（P0.05）;the level of serum β-EP had no significant difference at different time points（P0.05�

关 键 词：氟比洛芬酯 肺癌 免疫功能 Β-内啡肽 高迁移率族蛋白B1 

分 类 号：R614[医药卫生—麻醉学] R734.2[医药卫生—外科学]