右美托咪定对结核病大鼠的T淋巴细胞、NK细胞和γ-干扰素表达和肺损伤的影响  

Influences of pretreating with dexmedetomidine on the expression of T lymphocyte,natural killer cells,interferon-gamma,and lung injury in tuberculosis rats after operation

作　　者：唐怡敏[1] 洪凤珠 王进 刘民强[2] 韩亚坤[2] 余德慧 邓永聪 Tang Yimin;Hong Fengzhu;Wang Jin;Liu Minqiang;Han Yakun;Yu Dehui;Deng Yongcong(Department of Pulmonary Clinica1,the Third People's Hospital of Shenzhen,Guangdong Shenzhen 518112,China;Department of Anesthesiology,the Third People's Hospital of Shenzhen,Guangdong Shenzhen 518112,China)

机构地区：[1]深圳市第三人民医院肺科门诊,广东深圳518112 [2]深圳市第三人民医院麻醉科,广东深圳518112

出　　处：《新发传染病电子杂志》2021年第2期92-96,共5页Electronic Journal of Emerging Infectious Diseases

基　　金：广东省高水平临床重点专科(深圳市配套建设经费)资助(SZGSP010)。

摘　　要：目的观察右美托咪定(dexmedetomidine,DEX)预处理对结核病(tuberculosis,TB)大鼠CD3^(+)T淋巴细胞、CD4^(+)T淋巴细胞、CD8^(+)T淋巴细胞、自然杀伤细胞(natural killer cell,NK细胞)、γ-干扰素(interferon gamma,IFN-γ)表达及肺损伤的影响,为TB患者手术期间免疫保护提供参考。方法取SD大鼠30只,随机分为非结核对照组(C组)、结核+生理盐水对照组(T组)、结核+DEX 5μg/kg组(D1组)、结核+DEX 10μg/kg组(D2组)和结核+DEX 15μg/kg组(D3组),每组6只。采用流式细胞仪检测麻醉前30min(T0),手术后1h(T1)、4h(T2)及8h(T3)眼眶静脉血CD3^(+)T淋巴细胞、CD4^(+)T淋巴细胞、CD8^(+)T淋巴细胞、CD4^(+)T淋巴细胞/CD8^(+)T淋巴细胞比值、NK细胞及IFN-γ表达水平的变化;术后12h处死大鼠,观察肺组织的病理学改变。结果与T0比较,各组术后T淋巴细胞亚群、NK细胞及IFN-γ均出现抑制,但同一时点各组间T淋巴细胞亚群、NK细胞及IFN-γ的变化差异无统计学意义(P>0.05),且TB大鼠术后肺部炎症反应程度相似。结论TB大鼠围术期采用DEX预处理无明显免疫保护及肺保护作用,该药在TB患者中使用需谨慎。Objective To observe the influences of pretreating with dexmedetomidine(DEX)on the expression of CD3^(+)T lymphocyte,CD4^(+)T lymphocyte,CD8^(+)T lymphocyte,natural killer cell(NK cell),interferon-gamma(IFN-γ),and lung injury in tuberculosis(TB)rats after operation,to provide reference for immune protection of TB patients during operation.Methods Thirty Sprague Dawley(SD)rats were enrolled in this study,and were randomly divided into 5 groups,including non-tuberculosis control group(group C),tuberculosis^(+)saline control group(group T),tuberculosis^(+)DEX 5μg/kg group(group D1),tuberculosis^(+)DEX 10μg/kg group(group D2)and tuberculosis^(+)DEX 15μg/kg group(group D3)with 6 cases each.Blood samples were taken from the orbital venous at 30 min before anesthesia(T0),1 hour(T1),4 hours(T2)and 8 hours(T3)after operation,and CD3^(+)T lymphocyte,CD4^(+)T lymphocyte,CD8^(+)T lymphocyte,CD4^(+)/CD8^(+)ratio,NK cell,and interferon gamma(IFN-γ)expression were calculated with flow cytometer.The lung pathologies were examined 12 hours after operation.Results Compared with T0,the T lymphocyte subsets,NK cell and IFN-γin each group were inhibited.But there was no significant difference in the changes of T lymphocyte subsets,NK cell and IFN-γin each group(P>0.05),and the degree of pulmonary inflammation was similar at the same time point in each group.Conclusion There was no obvious immune protection and lung protection effect on TB rats pretreated with DEX during perioperative period.It has no lung protection effect on TB rats,thus it should be used cautiously in TB patients.

关 键 词：右美托咪定 结核病 T淋巴细胞 自然杀伤细胞 Γ-干扰素 

分 类 号：R614[医药卫生—麻醉学] R52[医药卫生—外科学]