艾司氯胺酮对宫颈癌经腹广泛子宫切除术患者应激反应、炎症反应和免疫反应的影响  

Effects of esketamine on stress response,inflammation response and immune response in patients with abdominal radical hysterectomy for cervical cancer

作　　者：李善快 张芳 林国雄 张美兰 周丹 LI Shankuai;ZHANG Fang;LIN Guoxiong;ZHANG Meilan;ZHOU Dan(Department of Anesthesiology,Shangrao People’s Hospital,Shangrao 334000,Jiangxi,China)

机构地区：[1]上饶市人民医院麻醉科,江西上饶3340000

出　　处：《癌症进展》2024年第18期2069-2072,共4页Oncology Progress

基　　金：江西省卫生健康委科技计划项目(202212741)。

摘　　要：目的探讨艾司氯胺酮(esk)对宫颈癌经腹广泛子宫切除术(ARH)患者应激反应、炎症反应和免疫反应的影响。方法将80例宫颈癌患者依据是否应用esk分为esk组(n=43)和参照组(n=37)。比较不同时间点[麻醉诱导前(T0)、术后苏醒即刻(T1)、术后1天(T2)、术后3天(T3)]两组患者应激反应指标[皮质醇(Cor)、血糖(Glu)、促肾上腺皮质激素(ACTH)]、免疫反应指标[CD4^(+)、CD8^(+)、CD3+、自然杀伤(NK)细胞、CD4^(+)/CD8^(+)]及炎症反应指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、白细胞介素-1β(IL-1β)]水平。结果T0~T3时间段,两组患者Cor、Glu、ACTH、TNF-α、IL-8、IL-1β水平均呈先上升后下降趋势,T1~T3时间段,esk组患者Cor、Glu、ACTH、TNF-α、IL-8、IL-1β水平均低于参照组,差异均有统计学意义(P﹤0.05)。T0~T3时间段,两组患者CD3+、CD4^(+)、NK细胞水平及CD4^(+)/CD8^(+)均呈先下降后上升趋势,T1~T3时间段,esk组患者CD3+、CD4^(+)、NK细胞水平及CD4^(+)/CD8^(+)均高于参照组,差异均有统计学意义(P﹤0.05)。结论esk应用于行ARH治疗的宫颈癌患者,可有效缓解机体应激反应和炎症反应,减轻机体免疫抑制,具有推广应用价值。Objective To investigate the effects of esketamine(esk)on stress response,inflammation response and immune response in patients with abdominal radical hysterectomy(ARH)for cervical cancer.Method A total of 80 patients with cervical cancer were divided into esk group(n=43)and reference group(n=37)according to whether esk was used.Stress response indexes[cortisol(Cor),blood glucose(Glu),adrenocorticotropic hormone(ACTH)],immune response indexes[CD4^(+),CD8^(+),CD3+,natural killer(NK)cell,CD4^(+)/CD8^(+)]and inflammatory response indicators[tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),interleukin-1β(IL-1β)]were compared between the two groups at different time points[before anesthesia induction(T0),awakening immediately after surgery(T1),1 day after surgery(T2),3 days after surgery(T3)].Result During T0-T3 period,the levels of Cor,Glu,ACTH,TNF-α,IL-8 and IL-1βin two groups were firstly increased and then decreased,and during T1-T3 period,the levels of Cor,Glu,ACTH,TNF-α,IL-8 and IL-1βin esk group were lower than those in reference group,the differences were statistically significant(P<0.05).During T0-T3 period,the levels of CD3+,CD4^(+),NK cell and CD4^(+)/CD8^(+)in two groups were firstly decreased and then increased,and during T1-T3 period,the levels of CD3+,CD4+,NK cell and CD4+/CD8+in esk group were higher than those in reference group,the differences were statistically significant(P<0.05).Conclusion The application of esk in cervical cancer patients treated with ARH can effectively relieve stress response and inflammatory response,reduce the immune suppression,and has the value of popularization and application.

关 键 词：艾司氯胺酮 宫颈癌 经腹广泛子宫切除术 应激反应 炎症反应 免疫反应 

分 类 号：R737.33[医药卫生—肿瘤]