地佐辛静脉自控镇痛对肺叶切除术后免疫功能的影响

发布时间：2018-04-23 04:30

本文选题：肺叶切除术 + 炎症因子　；参考：《中国医院药学杂志》2015年13期

【摘要】：目的:观察地佐辛静脉自控镇痛对肺叶切除术后免疫功能的影响。方法:选取60例拟行开胸肺叶切除术的患者随机分为对照组和DEZ组,每组30例。DEZ组术后PCA泵注0.5 mg·ml-1地佐辛,对照组术后PCA泵注0.9%氯化钠。采集患者麻醉诱导前(T0)、术后4 h(T1)、术后24 h(T2)和术后48 h(T3)血标本,测定血清CRP、TNF-α、IL-2、IL-6和IL-10水平,以及外周血淋巴细胞(L)计数及淋巴细胞中CD4+T淋巴细胞、CD8+T淋巴细胞、自然杀伤细胞(NK)比例的变化。于T1、T2和T3时点随访患者,记录患者视觉模拟评分(VAS)和数字镇静评分(NSS)。结果:肺叶切除术后患者血清CRP、TNF-α、IL-6和IL-10的水平较术前明显升高(P0.05),IL-2较术前降低(P0.05);术后外周血淋巴细胞计数及CD4+T淋巴细胞比例和NK细胞比例较术前降低(P0.05);地佐辛静脉自控镇痛能明显降低术后血清CRP、IL-6,升高IL-2及CD4+T淋巴细胞比例(P0.05);地佐辛组患者术后24 h的VAS评分低于对照组(P0.05)。结论:地佐辛静脉镇痛具有免疫调节作用,可改善肺叶切除术后的免疫抑制,并减轻炎症反应。
[Abstract]:Objective: to observe the effect of patient-controlled dizosin analgesia on immune function after lobectomy. Methods: sixty patients undergoing lobectomy were randomly divided into two groups: control group (n = 30) and DEZ group (n = 30). The PCA pump of 0.5 mg ml-1 was injected into the control group, and the PCA pump was injected with 0.9% sodium chloride in the control group. The blood samples were collected before anesthesia induction, 4 hours after operation, 24 hours after operation, 24 hours after operation and 48 hours after operation. The serum levels of IL 2, IL 2 and IL-10, the count of CD4 T lymphocytes and CD8 T lymphocytes in peripheral blood lymphocytes were measured. Changes in NK ratio of natural killer cells. Visual analogue scores (VASs) and digital sedation scores (NSS) were recorded at T _ 1 T _ 2 and T _ 3 follow-up. Results: the serum levels of TNF- 伪 IL-6 and IL-10 in patients after lobectomy were significantly higher than those before operation (P 0.05) and IL-2 was significantly lower than that before operation (P 0.05), the peripheral blood lymphocyte count, the ratio of CD4 T lymphocytes and NK cells were lower than those before operation (P 0.05), and the dizoxin vein was significantly lower than that before operation (P 0.05). Patient controlled analgesia significantly decreased the serum CRP IL-6, increased the ratio of IL-2 and CD4 T lymphocytes, and significantly decreased the VAS score of the patients in the dizoxin group at 24 hours after operation compared with the control group (P 0.05). Conclusion: dizosin intravenous analgesia has immunomodulatory effect, which can improve the immunosuppression after lobectomy and alleviate the inflammatory reaction.
【作者单位】：华中科技大学同济医学院附属同济医院麻醉科;深圳市第二人民医院麻醉科;
【基金】：国家自然科学基金资助项目(编号:81341034) 深圳市科技创新委员会国际合作项目(编号:GJHZ20120614154624545) 深圳市科技创新委员会知识创新计划(编号:JCYJ2013041113227462)
【分类号】：R614

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