七氟醚与异氟醚用于肺癌根治术的麻醉效果及对血清基质金属蛋白酶、炎性因子、E-选择素及环氧合酶-2水平的影响  

Efficacy of sevoflurane and isoflurane in radical operation for lung cancer and their effects on serum MMPS expression,inflammatory factors,E-selectin and COX-2 levels

作　　者：肖凤霞 黄铁刚 XIAO Fengxia;HUANG Tiegang(Department of Anesthesiology,Hubei Hanchuan People's Hospital,Xiaogan 431600,China)

机构地区：[1]汉川市人民医院麻醉科,湖北孝感431600

出　　处：《临床外科杂志》2023年第7期682-685,共4页Journal of Clinical Surgery

摘　　要：目的探讨七氟醚与异氟醚用于肺癌根治术的效果及对血清基质金属蛋白酶(MMPs)表达、炎性因子、E-选择素(E-selectin)及环氧合酶-2(COX-2)水平的影响。方法2017年5月~2020年12月行三孔胸腔镜肺癌根治术治疗的肺癌病人86例,按照随机数字表法分为观察组(术中使用七氟醚维持麻醉)与对照组(术中使用异氟醚维持麻醉),每组各43例;对比两组术前(T_(0))、手术开始1小时(T_(1))、术毕(T_(2))、术后6小时(T_(3))等时点的基质金属蛋白酶(MMP)-2、MMP-9、E-selectin、COX-2、白细胞介素(IL)-4、IL-10、IL-6水平变化;评估苏醒时间、拔管时间、自主呼吸恢复、住院时间。结果在T_(1)、T_(2)、T_(3)时点,观察组的MMP-2分别为(328.11±23.15)ng/L、(335.41±23.85)ng/L、(342.52±25.52)ng/L,MMP-9分别为(357.01±24.02)ng/L、(365.85±25.69)ng/L、(375.01±27.01)ng/L,E-selectin分别为(59.11±6.02)ng/ml、(65.18±6.15)ng/ml、(57.25±5.69)ng/ml,COX-2分别为(21.15±2.11)ng/ml、(22.05±2.18)ng/ml、(22.35±2.02)ng/ml,IL-4分别为(14.11±2.65)ng/ml、(17.23±3.21)ng/ml、(22.01±3.96)ng/ml,IL-10(5.96±0.32)ng/ml、(7.25±0.58)ng/ml、(11.02±1.32)ng/ml,IL-6(44.12±3.41)ng/ml、(56.23±4.02)ng/ml、(57.14±4.09)ng/ml;对照组MMP-2分别(341.52±25.45)ng/L、(368.78±28.74)ng/L、(381.02±31.03)ng/L,MMP-9分别为(369.78±26.45)ng/L、(387.45±29.65)ng/L、(410.52±34.02)ng/L,E-selectin分别为(64.12±7.25)ng/ml、(72.36±8.45)ng/ml、(62.15±6.45)ng/ml,COX-2分别为(25.26±3.33)ng/ml、(25.35±3.28)ng/ml、(25.75±3.36)ng/ml,IL-4分别为(15.96±3.12)ng/ml、(22.69±4.52)ng/ml、(27.41±4.32)ng/ml,IL-10(7.12±0.55)ng/ml、(9.96±1.02)ng/ml、(15.21±1.96)ng/ml,IL-6(59.78±4.85)ng/ml、(77.65±5.32)ng/ml、(62.65±5.05)ng/ml;观察组T_(1)、T_(2)、T_(3)时点的MMP-2、MMP-9、E-selectin、COX-2、IL-4、IL-10、IL-6均低于对照组,差异有统计学意义(P<0.05)。观察组与对照组的苏醒时间分别为(20.21±2.32)分钟和(27.12±3.15)分钟,拔管时间分别为(24.Objective To investigate the effect of sevoflurane and isoflurane in radical resection of lung cancer and their effects on the expression of serum matrix metalloproteinases(MMPs),inflammatory factors,E-selectin(E-selectin)and cyclooxygenase-2(COX-2)level effect.Methods Lung cancer patients who underwent three-hole thoracoscopic radical resection for lung cancer from May 2017 to December 2020 were selected as the study objects,and were divided into observation group(intraoperative anesthesia maintained by sevoflurane)and control group(intraoperative anesthesia maintained by isoflurane)according to random number table,with 43 cases in each group.The level changes of matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9),E-selectin,COX-2,interleukin-4(IL-4),interleukin-10(IL-10)and interleukin-6(IL-6)of the two groups were compared before surgery(T_(0)),1h after surgery(T_(1)),after surgery(T_(2)),and 6h after surgery(T_(3)).Recovery time,extubation time,recovery of spontaneous respiration,and length of hospital stay were evaluated.Results At T_(1),T_(2) and T_(3),the MMP-2 levels of the observation group were(328.11±23.15)ng/L,(335.41±23.85)ng/L,(342.52±25.52)ng/L,respectively.MMP-9 was(357.01±24.02)ng/L,(365.85±25.69)ng/L,(375.01±27.01)ng/L,respectively.E-selectin values were(59.11±6.02)ng/ml,(65.18±6.15)ng/ml,(57.25±5.69)ng/ml,respectively.COX-2 was(21.15±2.11)ng/ml,(22.05±2.18)ng/ml,(22.35±2.02)ng/ml,respectively.IL-4 was(14.11±2.65)ng/ml,(17.23±3.21)ng/ml,(22.01±3.96)ng/ml,respectively.IL-10 was(5.96±0.32)ng/ml,(7.25±0.58)ng/ml,(11.02±1.32)ng/ml,respectively.IL-6 was(44.12±3.41)ng/ml,(56.23±4.02)ng/ml,(57.14±4.09)ng/mlrespectively.In control group,MMP-2 was(341.52±25.45)ng/L,(368.78±28.74)ng/L,(381.02±31.03)ng/L,respectively.MMP-9 was(369.78±26.45)ng/L,(387.45±29.65)ng/L,(410.52±34.02)ng/L,respectively.E-selectin values were(64.12±7.25)ng/ml,(72.36±8.45)ng/ml,(62.15±6.45)ng/ml,respectively.COX-2 was(25.26±3.33)ng/ml,(25.35±3.28)ng/ml,(25.75±3.36)ng/ml,respectively.I

关 键 词：七氟醚 异氟醚 肺癌根治术 炎性因子 基质金属蛋白酶 环氧合酶 E-选择素 

分 类 号：R614[医药卫生—麻醉学] R734.2[医药卫生—外科学]