丙泊酚与七氟醚对结直肠癌根治术患者缺氧诱导因子-1水平的影响  

Effects of propofol and sevoflurane on hypoxia inducible factor -1 levels in patients of undergoing radical resection of colorectal cancer

作　　者：徐桂萍[1] 后晓超 

机构地区：[1]新疆维吾尔自治区人民医院麻醉科,乌鲁木齐830000 [2]新疆医科大学研究生学院,乌鲁木齐830011

出　　处：《国际麻醉学与复苏杂志》2017年第11期967-969,992,共4页International Journal of Anesthesiology and Resuscitation

基　　金：国家自然科学基金（81160016）

摘　　要：探讨丙泊酚与七氟醚对结直肠癌根治术患者围手术期血清缺氧诱导因子-1（hypoxia inducible factor-1， HIF-1）的影响。 方法 选择符合纳入标准结直肠癌根治术患者40例，采用随机数字表法分为两组：丙泊酚组（P组）和七氟醚组（S组），每组20例。P组采用全凭静脉全身麻醉，常规静脉诱导，靶控输注（target-controlled infusion， TCI）丙泊酚，术中维持：瑞芬太尼TCI、丙泊酚TCI。S组采用静吸复合全身麻醉，常规静脉诱导，术中维持：瑞芬太尼TCI、七氟醚吸入。于麻醉前30 min（T0）、手术结束即刻（T1）、术后24 h（T2）时采集患者颈内静脉血样4 ml，采用双抗体夹心ELISA法检测HIF-1血清浓度。 结果 P组T1时点HIF-1浓度小于T0时点，差异有统计学意义（P＜0.05）。S组T1时点HIF-1浓度大于T0时点，差异有统计学意义（P＜0.05）。与P组比较，S组T1时点HIF-1浓度升高（P＜0.05）。 结论 丙泊酚可以使结直肠癌患者血清HIF？蛳1的浓度降低，而七氟醚上调其表达水平，提示丙泊酚更适用于此类患者，对肿瘤后期治疗及康复有意义。Objective To investigate the effects of propofol and sevoflurane on radical resection of colorectal cancer patients with preoperative serum hypoxia inducible factor-1（HIF-1） effect. Methods Forty patients with colorectal cancer radical surgery were randomly divided into 2 groups on experimental standard, propofol group （group P）, sevoflurane group （group S） （n=20）. Group P use intravenous anesthesia, routine intravenous induction of propofol by target controlled infusion（TCI）. Intraoperative maintenance： remifentanil TCI, propofol TCI. Group S, intravenous and inhalational balanced anesthesia, routine intravenous induction and maintenance of anesthesia in： remifentanil TCI, sevoflurane maintenance. During the 30 min before anesthesia （T0）, immediately after surgery （T1） and 24 h （T2） after operation, 4 ml blood samples were collected from the patient＇s internal jugular vein. The serum concentration of HIF-1 was detected by double antibody sandwich ELISA. Results Group P T1 time HIF-1 level was less than the level of T0 time, the difference was statistically significant （P〈0.05）. HIF-1 level of Group S at T1 time is higher than level of T0. The difference was statistically significant （P〈0.05）. Compared with group P and group S, the HIF-1 concentration increased at T1 （P〈0.05）. Conclusions Propofol can reduce serum HIF-1 level whereas sevoflurane increased its expression level. It is suggested that propofol is more suitable anesthesia method for this kind of patient, and it is significant for the treatment and rehabilitation of tumor.

关 键 词：丙泊酚 七氟醚 缺氧诱导因子-1 

分 类 号：R614[医药卫生—麻醉学] R735.34[医药卫生—外科学]