术中静注利多卡因对乳腺癌T淋巴细胞平衡的影响  

Effect of Intraoperative Intravenous Lidocaine Infusion on T Lymphocyte Balance in Breast Cancer Patients

作　　者：祁向雯 李洪影 毛珊珊 庞红利[1] QI Xiangwen;LI Hongying;MAO Shanshan;PANG Hongli(The First Affiliated Hospital of Henan University,Kaifeng,Henan 475000,China)

机构地区：[1]河南大学第一附属医院,河南开封475000

出　　处：《今日药学》2023年第4期301-305,共5页Pharmacy Today

基　　金：开封市科技计划项目(2103024)。

摘　　要：目的探讨术中静脉输注利多卡因对乳腺癌患者T淋巴细胞平衡的影响。方法选取2021年1月~2022年6月在某院行乳腺癌手术的患者84例,按随机数字表法将其均分为对照组和观察组,每组42例。对照组采用常规麻醉,观察组采用术中静脉输注利多卡因麻醉方案。采用酶联免疫吸附法检测麻醉诱导前30 min(T0)、手术开始后30 min(T1)、手术结束即刻(T2)及术后6 h时(T3)时血清白细胞介素-4(IL-4)、干扰素-γ(IFN-γ)、白细胞介素-17(IL-17)、白细胞介素-35(IL-35)水平,采用流式细胞仪检测辅助性T细胞1(Th1),辅助性T细胞2(Th2)、辅助性T细胞17(Th17)和调节性T细胞(Terg)百分比。结果观察组患者血清IFN-γ、IFN-γ/IL-4及Th1/Th2在T1、T2、T3时均明显高于对照组(P<0.05)。观察组患者血清IL-17水平在T2、T3时均低于对照组(P<0.05),观察组患者血清IL-35水平在T1、T2、T3时均明显高于对照组,IL-17/IL-35及Th17/Terg均低于对照组(P<0.05)。结论术中静脉输注利多卡因能有效抑制乳腺癌患者Th1/Th2、Th17/Terg失衡,有利于维持T淋巴细胞平衡稳定。OBJECTIVE To investigate the effect of intraoperative intravenous infusion of lidocaine on T lymphocyte balance in breast cancer patients.METHODS A total of 84 patients who underwent breast cancer surgery in a hospital from January 2021 to June 2022 were selected and divided into control group and observation group according to the random number table method,with 42 cases in each group.The control group received conventional anesthesia,and the observation group received intraoperative intravenous infusion of lidocaine.Serum interleukin⁃4(IL⁃4),interferon⁃γ(IFN⁃γ),interleukin⁃17(IL⁃17)and interleukin⁃35(IL⁃35)were detected by enzyme⁃linked immunosorbent assay at 30 min before anesthesia induction(T0),30 min after operation(T1),immediately after operation(T2)and at 6 hours after operation(T3).And the percentages of helper T cell 1(Th1),helper T cell 2(Th2),helper T cell 17(Th17),and regulatory T cell(Terg)were detected by flow cytometry.RESULTS The serum levels of IFN⁃γ,IFN⁃γ/IL⁃4 and Th1/Th2 in the observation group were significantly higher than those in the control group at T1,T2 and T3(P<0.05).The serum level of IL⁃17 in the observation group was lower than those in the control group at T2 and T3(P<0.05).The serum level of IL⁃35 in the observation group was significantly higher than those in the control group at T1,T2 and T3,and the levels of IL⁃17/IL⁃35 and Th17/Terg were lower than those in the control group(P<0.05).CONCLUSION Intraoperative intravenous infusion of lidocaine can effectively inhibit the imbalance of Th1/Th2 and Th17/Terg in breast cancer patients,which is beneficial to maintain the balance and stability of T lymphocytes.

关 键 词：利多卡因 乳腺癌 T淋巴细胞 TH1/TH2 Th17/Terg 

分 类 号：R614[医药卫生—麻醉学]