不同剂量甲强龙对行胸腔镜肺癌根治术患者免疫功能的影响  

Effects of Different Doses of Methylprednisolone on the Immune Function of Patients undergoing Radical Resection of Pulmonary Carcinoma Performed via Video-assisted Thoracoscope

作　　者：李秀艳[1] 白文娅 滕秀飞 杨延超[1] 李阳[1] 朱俊超[1] 

机构地区：[1]中国医科大学附属盛京医院麻醉科,辽宁沈阳110016

出　　处：《现代生物医学进展》2017年第28期5453-5456,共4页Progress in Modern Biomedicine

基　　金：辽宁省自然科学基金项目(20102282);中国医科大学盛京医院三新项目(2016PS122J)

摘　　要：目的:评价不同剂量甲强龙对行胸腔镜肺癌根治术患者免疫功能的影响。方法:选择择期行胸腔镜肺癌根治术患者40例,美国麻醉医师学会(American Society of Anesthesiology,ASA)Ⅱ~Ⅲ级,性别不限,年龄65~85岁,采用随机数字表法分为两组(n=20):甲强龙高剂量组(M组)和甲强龙低剂量组(C组)。在麻醉诱导前30 min,M组静脉注射甲强龙1 mg·kg-1,C组静脉注射甲强龙0.5 mg·kg-1。于诱导前(T0)、术毕(T1)、术后24 h(T2)抽取外周静脉血样,采用流式细胞术测定T淋巴细胞亚群CD3^+、CD4^+、CD8^+水平,计算CD4^+/CD8^+比值。结果:与T0时比较,M组T1和T2时CD3^+水平显著降低(P<0.05),CD4^+水平、CD4^+/CD8^+比值有所降低,CD8^+水平有所升高,但是差异无统计学意义(P>0.05);C组T1和T2时CD3^+、CD4^+、CD8^+水平以及CD4^+/CD8^+比值差异无统计学意义(P>0.05)。与C组比较,M组T1和T2时CD3^+水平降低,T2时CD8^+水平显著升高(P<0.05)。结论:麻醉诱导前30min静脉注射1 mg·kg^(-1)的甲强龙对行胸腔镜肺癌根治术患者的免疫功能有一定影响,而麻醉诱导前30 min静脉注射0.5 mg·kg^(-1)的甲强龙对患者的免疫功能无明显影响。Objective： To evaluate the effects of different doses of methylprednisolone on the immune function of patients undergoing radical resection of pulmonary carcinoma performed via video-assisted thoracoscope. Methods： Forty patients of both gender, aged 65-85 yr, American Society of Anesthesiologists physical status II-III, scheduled for radical resection of pulmonary carcinoma performed via video-assisted thoracoscope under general anesthesia were randomly divided into two groups （n = 20 each）： high-dose of methylprednisolone group （group M） and low-dose of methylprednisolone （group C）. At 30 minutes prior to the induction of anesthesia, methylprednisolone 1 mg·kg^-1 was injected intra-venously in group M, and 0.5 mg·kg^-1 was injected intra-venously in group C. Before the induction of anesthesia （TO）, immediately after surgery （T1）, at 24 h after surgery （T2）, the venous blood samples were collected to detect the levels of T lymphocyte subsets CD3^＋,CD4^＋ and CD8^＋ （by flow cytometry）. CD4^＋/CD8^＋ ratio was calculated. Results： Compared with the values at TO, the levels ofCD3^＋ was decreased at the time points ofT1 and T2 （P〈0.05）, the levels of CD4^＋, and the ratio of CD4^＋/CD8^＋ were decreased, the level of CD8^＋ was increased, but there was no significant difference compared with the values at TO in group M （P 〈 0.05）, and no significant change was found in the levels of CD3^＋, CD4^＋, CD8^＋ and the ratio of CD4^＋/CD8^＋ in group C （P 〈 0.05）. Compared with the group C, the levels of CD3^＋ were decreased at the time points of T1 and T2, and the level of CD8^＋ was increased at the time points of T2 （P 〈 0.05）. Conclusions： Methylprednisolone injected intravenously at a dose of 1 mg/kg 30 mins before the induction of anesthesia could exert negative influence on the immune function of patients undergoing radical resection of pulmonary carcinoma performed via video-assisted thoracoscope, while no significant influence oc

关 键 词：甲强龙 免疫功能 肺癌 胸腔镜 

分 类 号：R734.2[医药卫生—肿瘤]