丙泊酚和异氟醚对原发性肝癌患者手术前后免疫细胞及肿瘤标志物的影响  

Effects of Propofol and Isoflurane on Immune Cells and Tumor Markers in Patients with Primary Liver Cancer Before and After Operation

作　　者：周侃 梁杰 秦延臣 杜飞 Zhou Kan;Liang Jie;Qin Yanchen;Du Fei(Department of Anesthesiology,Jiaozuo Second People′s Hospital,Jiaozuo 454002 China)

机构地区：[1]焦作市第二人民医院麻醉科,河南焦作454002

出　　处：《锦州医科大学学报》2023年第3期85-88,共4页Journal of Jinzhou Medical University

基　　金：2019年度河南省医学科技攻关计划联合共建项目,项目编号:LHGJ20191337。

摘　　要：目的探讨丙泊酚和异氟醚对原发性肝癌患者手术前后免疫细胞及肿瘤标志物的影响。方法选取2014年3月至2017年2月在焦作市第二人民医院行肝部分切除手术的108例原发性肝癌患者,按随机数字表法分为丙泊酚组与异氟醚组,每组各54例。两组患者在采取肝叶切除术时分别予以不同麻醉。统计两组不良反应发生率。比较麻醉前和术后T淋巴细胞亚群(CD^(3+)、CD^(4+)、CD^(8+)及CD^(4+)/CD^(8+))及MMPS基质金属蛋白酶、VEGF血管内皮生长因子、血清可溶性E-钙蛋白水平。记录两组生存情况。结果丙泊酚组患者不良反应发生率均显著低于异氟醚(P<0.05)。丙泊酚组患者术后24 h时CD^(3+)、CD^(4+)降低程度显著小于异氟醚组(P<0.05)。丙泊酚组患者术后14 d时MMP、VEGF、EC降低程度显著高于异氟醚组(P<0.05)。两组患者随访3年期间生存率比较差异无统计学意义(P>0.05)。结论与异氟醚相比,丙泊酚能有效改善原发性肝癌患者术后免疫抑制状态,降低不良反应发生率,可能有利于患者术后康复。Objective To investigate the effects of propofol and isoflurane on immune cells and tumor markers in patients with primary liver cancer before and after operation.Methods 108 patients with primary liver cancer undergoing partial hepatectomy in our hospital from March 2014 to February 2017 were randomly divided into propofol group and isoflurane group,with 54 cases in each group.Patients in the two groups were given different anesthesia during lobectomy.The incidence of adverse reactions in the two groups was statistically analyzed.T lymphocyte subsets(CD^(3+),CD^(4+),CD^(8+)and CD^(4+)/CD^(8+))and MMPS matrix metalloproteinase,VEGF vascular endothelial growth factor,serum soluble E-calpain levels were compared before and after anesthesia.The survival of the two groups was recorded.Results The incidence of adverse reactions in propofol group was significantly lower than that in isoflurane group(P<0.05).The reduction of CD^(3+)and CD^(4+)in propofol group was significantly lower than that in isoflurane group 24 h after surgery(P<0.05).The reduction degree of MMP,VEGF and EC in propofol group was significantly higher than that in isoflurane group 14 days after surgery(P<0.05).There was no significant difference in survival rate between the two groups during 3-year follow-up(P>0.05).Conclusion Compared with isoflurane,propofol can effectively improve the immunosuppressive state of patients with primary liver cancer after operation and reduce the incidence of adverse reactions,which may be conducive to postoperative rehabilitation of patients.

关 键 词：丙泊酚 异氟醚 原发性肝癌 免疫细胞 肿瘤标志物 

分 类 号：R735.7[医药卫生—肿瘤]