帕瑞昔布+右美托咪定对胸腔镜手术麻醉恢复期全身炎症及氧化应激反应的影响  

Effects of parecoxib + dexmedetomidine on systemic inflammation and oxidative stress during anesthesia recovery period of thoracoscopic surgery

作　　者：韩庆波[1] 刘洋[1] 王振华[1] 郭平选[1] 李君妍 HAN Qing-bo;LIU Yang;WANG Zhen-hua;GUO Ping-xuan(Anesthesiology Department, Kailuan General Hospital of Tangshan Hebei Province, Tangshan, Hebei Province, 063000, China)

机构地区：[1]河北省唐山市开滦总医院麻醉科,河北唐山063000

出　　处：《海南医学院学报》2019年第10期779-783,共5页Journal of Hainan Medical University

基　　金：河北省卫生和计划生育委员会科研基金项目(20160753)~~

摘　　要：目的:研究帕瑞昔布+右美托咪定对胸腔镜手术麻醉恢复期全身炎症及氧化应激反应的影响。方法:选择在本院接受胸腔镜下手术的肺癌患者作为研究对象,随机分为接受帕瑞昔布+右美托咪定超前镇痛联合常规麻醉的实验组、接受常规麻醉的对照组。术后3、5 d时,采集血清并测定炎症细胞因子干扰素-γ(IFN-γ)、白细胞介素(IL)-1β、IL-18、细胞间黏附分子1(ICAM1)、单核细胞趋化蛋白1(MCP1)及氧化应激介质皮质醇(COR)、丙二醛(MDA)、内皮素-1(ET-1)、超氧化物歧化酶(SOD)、总抗氧化力(T-AOC)的含量,采集外周抗凝血并测定炎症信号分子Toll样受体4(TLR4)、NOD样受体蛋白3(NLRP3)、核因子-κB(NF-κB)、凋亡相关点样蛋白(ASC)、含半胱氨酸的天冬氨酸蛋白水解酶1(Caspase-1)及氧化应激分子核因子E2相关因子2(NRF2)、抗氧化反应元件(ARE)、NADPH氧化酶(NOX)2、NOX4的表达量。结果:术后3、5 d时,实验组血清中IFN-γ、IL-1β、IL-18、ICAM1、MCP1、COR、MDA、ET-1的含量以及外周血中TLR4、NLRP3、NF-κB、ASC、Caspase-1、NRF2、ARE、NOX2、NOX4的表达强度均显著低于对照组,血清中SOD、T-AOC的含量高于对照组。结论:帕瑞昔布+右美托咪定对胸腔镜手术麻醉恢复期全身炎症及氧化应激反应具有抑制作用。Objective: To study the effects of parecoxib + dexmedetomidine on systemic inflammation and oxidative stress during anesthesia recovery period of thoracoscopic surgery. Methods: The lung cancer patients undergoing thoracoscopic surgery in Kailuan General Hospital between March 2015 and February 2018 were selected as the research subjects and randomly divided into the experimental group who received parecoxib + dexmedetomidine preemptive analgesia combined with conventional anesthesia and the control group who received conventional anesthesia. 3 and 5 d after surgery, serum was collected to measure the contents of inflammatory cytokines Interferon-γ(IFN-γ), interleukin-1β(IL-1β), interleukin-18(IL-18), intercellular adhesion molecule-1 (ICAM1), monocyte chemoattractant protein-1 (MCP1)as well as oxidative stress mediators Cortisol (COR), Malondialdehyde (MDA), Endothelin-1 (ET-1), Superoxide Dismutase (SOD), Total Antioxidant Capacity (T-AOC) and peripheral anticoagulant blood was collected to measure the expressions of inflammatory signaling molecules Toll-like receptor 4 (TLR4), NOD-like receptor protein 3 (NLRP3), nuclear factor-kappa B (NF-kappa B), apoptotic point-like protein (ASC), Cysteine-containing aspartic acid proteolytic enzymes-1(caspase-1) as well as oxidative stress molecules Nuclear factor E2 related factor 2 (NRF2), antioxidant response element (ARE), NADPH oxidase (NOX) 2, NOX4. Results: 3 and 5 days after surgery, serum IFN-γ, IL-1β, IL-18, ICAM1, MCP1, COR, MDA and ET-1 contents as well as peripheral blood TLR4, NLRP3, NF-κB, ASC, Caspase-1, NRF2, ARE, NOX2 and NOX4 expression intensity of the experimental group were significantly lower than those of the control group whereas serum SOD and T-AOC contents were higher than those of the control group. Conclusion: Parecoxib + dexmedetomidine can inhibit the systemic inflammation and oxidative stress during anesthesia recovery period of thoracoscopic surgery.

关 键 词：胸腔镜手术 帕瑞昔布钠 右美托咪定 炎症反应 氧化应激反应 

分 类 号：R614[医药卫生—麻醉学]